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Analysis of the Effects on Fee-for-Service and DRGs in New Rural Cooperative Medical Scheme

Author: WangLiYang
Tutor: ChenYingChun
School: Huazhong University of Science and Technology
Course: Social Medicine and Health Management
Keywords: The new type of rural cooperative medical care Payment Effect
CLC: R197.1
Type: Master's thesis
Year: 2007
Downloads: 436
Quote: 2
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Abstract


With the rapid spread of the new rural cooperative medical, how to control health care costs from the supply-side perspective, the important content areas for research to improve service quality, but the payment is one important way. Fee and two single disease Quota Payment Payment in pilot areas, the need to analyze their effect to continue to reform and improve the the cooperative medical costs Payment better play the role of the cooperative medical care. Objective To analyze the effect of the new type of rural cooperative medical care paid by the project and fixed pay both Payment single disease control in the quality of medical services, medical expenses, and in-depth analysis of the different effects produced by the internal mechanism and outside explore appropriate payment influencing factors, as well as to protect the effective operation of conditions of payment methods, the new rural cooperative medical unreasonable price increases effectively control health costs, improve the quality of medical services and standardize the role of health behavior, the ultimate protection NCMS a good run, to play a role to ease the farmers' burden of disease, and better services for farmers. Method 1. Documentary research: access to domestic and international pay and single disease fixed fee for the summary, the literature of the mechanism of action, the effect of the two methods of payment. Research: County Health Bureau of the investigation area, the county and township levels cooperative medical agencies, county and township medical institutions conducted a questionnaire survey of relevant management personnel, medical staff and patients 76 (times) interviews. Extract each survey area county hospital inpatient charges and the analysis of the quality of treatment and two township hospitals a total of 418 copies of Appendicitis medical records. 3. Use of medical insurance theory to analyze and interpret the results. Statistical methods: the application of descriptive statistics analysis, the mean of two independent samples t-test and chi-square test statistical methods to analyze the survey results. 1 pay-per-project incentive for parties to provide more services at the same time to bring the pilot early medical expenses rapid growth, but to strengthen the regulation, the cost of the growth rate of a certain degree of control. . Limit management fee mode limit per inpatient charges, the highest single disease costs limits, all costs by limiting the medical supply-side cases, the amount of the cost of the highest single disease, on the supply side in excess of the limit over-provide services not only to make profits, but will also increase the cost to some extent inhibited the supply-side over-enthusiasm of services. 3. Paid by the project implementation process in some districts limit ineffective implementation. 4. Single disease fixed payment to determine the cost of single disease appendicitis play a certain role in the control, and promote the hospital sub-disease costs lump sum taken to control the cost of services, enhance the reasonable use of the designated medical institutions control and other measures to change the clinic behavior. 5. Changes in the cost of medical care and the change in the behavior of the medical staff affected by many factors, Payment is not the only factor, at the same time, the role play of Payment is also influenced by other factors. Survey area to adopt a variety of strategies to strengthen supervision, including the implementation of the quota paid to strengthen the supervision of drug use, the introduction of competition mechanism, strengthen democratic supervision, increase the intensity of the audit, control referral, the development and use of diagnostic and treatment practices, so that respective Payment defects have been certain make up, play a role better. 7. Managerial inputs the larger investigation Payment to play better. Conclusion: 1. According to local conditions, the appropriate choice of payment methods. Mixed payment can give full play to the role of control costs and guarantee quality. Establish a long-term regulatory mechanism to ensure the effective implementation of the regulatory system of health care providers focus. protect the financial support cooperative medical management funding to promote cooperative medical management agency management capabilities 5. reform of the internal management mechanism to encourage medical institutions

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CLC: > Medicine, health > Preventive Medicine,Health > Health care organizations and career ( Health Management ) > Health care systems and institutions > Health care system
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