The Running Effect Evaluation Reform About The Urban And Rural Residents Medical Insurance Payment Reform As A Whole In Hospital In Yanchi

Objective: Through the effect evaluation of the existing county hospital as a whole lumpall-in budget payment system of rural residents of operation. Analysis of the problemsexisting in the operation. complete the quality control measures of county hospital supplysystem. For the reform of rural residents medical insurance payment was in the hospital as awhole and promotion.Methods: From the existing health care center, the existing hospitals at the county levelto understand the operation condition of rural residents in the hospital and expenditure. Themain analysis indicators are hospitalized shunt circumstance, be in hospital cost controlsituation, the patients’ medical burden and medical institutions and ginseng protect farmers’satisfaction, fund use and risk analysis, etc.Using Epidata3.02to entry the data, and usingSPSS18.0statistical analysis software to analysis of the data.Results:1、Patients with the same period in2011-2013rural residents in the countyhospital hospitalization rates, people split ratio, total cost of diversion ratio, cancel afterverification cost split ratio showed a trend of increasing year by year.2、County hospital,hospital of traditional Chinese people showed a trend of increasing year by year; Outside thecounty hospital medical institutions people showed a trend of decreasing year by year..3、County hospital, hospital of traditional Chinese total cost showed a trend of increasing year byyear; Outside the county medical institutions in the hospital total cost decreasing trend year by year.4、County hospital and county hospital inpatient reimbursement costs rising trend on thewhole, outside the county medical institutions in the hospital total cost decreasing trend yearby year.5、Ginseng protect rural residents from2011to2013out-of-pocket costs accountedfor the proportion of the total costs are67.59%,58.32%and51.09%respectively, since thepay cost, all out-of-pocket costs continue to drop.6、The existing ariations county hospitalthree years almost have no change.7、Rural hospitalized patients overall satisfaction to theevaluation of the existing medical institutions at the county level is highe, but the medicalexpenses and expenses for the satisfaction of the types of drugs is low.8、The existing numberof ginseng to three years showed a trend of decline. Three years as a whole fund has balance,maintain good and is on the rise. Hospital as a whole of fund utilization rate rising trend yearby year, capital cost overruns by2013. Lump sum funds appeared two years practice overrunsin hospital.Conclusion: Supply system in hospital institutional framework and operationmechanism has been basically formed, are also constantly improve management system. Theimplementation of the project to guide the patients to the medical institutions at the countylevel, reduce the ginseng protect rural residents medical treatment cost; Increased utilizationof funds, make people of individual pay scale to drop, to a certain extent, reduce the pressureof the farmers’ medical; The establishment of the effective regulation. The problem in theoperation:(1) the existing three years service rate showed a trend of decreasing year by year,the fund size is reduced, will reduce health care of anti-risk ability;(2) in the projectimplementation stage, ginseng protect farmers hospitalization medical expenses rises,hospitalization rates rise too fast, the hospital as a whole of fund utilization rate is higher,have overruns risk;(3) the project for two years, the existing two pilot county of ginsengprotect farmers hospital medical institutions reimburse all costs beyond all-in budget at thestart of the year, On the one hand may be linked to two county-level hospitals after executionin the hospital as a whole fund supply system, the hospital internal related management mechanism is not perfect, on the other hand may be linked to responsibility cost estimates inthe definition is too broad of hospital can cure diseases, causing diseases in lump sum toreferral of patients with larger proportion, expense claims as a whole.Recommendations:1、Establish a more complete all-in hospital capital estimationprogram.2、Should strengthen the quality of medical service and improve satisfaction ofinpatients.3、Continue to strengthen medical institutions internal regulation, reduce the fundoperation risk.4、Improve the staff enthusiasm.5、To further intensify policy propaganda.6、To strengthen the collaboration between the various units and ensure the smooth progress ofhospital responsibility budget system.