Analysis On The Current Expenses Status Of Type 2 Diabetes Mellitus Joined In Rural And Urban Medical Insurance System In A Public Hospital In Guangzhou

BackgroundThe heavy burden of diabetes In recent years,the number of people with diabetes is growing rapidly.The number of adult diabetic patients worldwide in 2017 is up to 451 million,and this data will rise to 693 million by 2045.Diabetes and its complications increase the risk of death from all causes and cardiovascular disease,and about 5 million people worldwide are dying of diabetes.Diabetes causes the burden of disease,medical and health economic burden on the global scale,which seriously affects the national health and economic development.Therefore,reducing the incidence of diabetes and its complications and reducing the burden of diabetes are the important targets of the disease prevention and control work in the global health field.Research status on diagnosis and treatment of diabetes The degree of standardization of diagnosis and treatment in various regional institutions in China is not consistent.Even in the 70 top diabetes centers in the country,only 53.3%diabetes centers are in accordance with clinical guidelines.The endocrine experts are discussing the future trend of diabetes clinical standard treatment,focus on the diabetes clinical application of expert consensus,combined with evidence-based medicine,to provide more practical basis and clinical medication guidelines for clinicians and scientific reference for clinical medication needs.The reform course of medical insurance payment In recent years,in order to cope with the rising cost of medical insurance payment challenges,all parts of the country have actively tried to reform the mode of payment of medical insurance and the management of standard cost management.In June 2017 the State Council further deepen the reform of the basic medical insurance payment,focuse on the implementation of DRGs payment according to the score,explore the establishment of DRGs payment system,strengthen Medicare for medical behavior supervision,give full play to the service of medical institutions and medical insurance institutions behavior incentive effect.Since 2018,the medical insurance settlement method of diabetes inpatient in Guangzhou will enter the situation of paying by the value of the disease.Purpose and SignificanceChronic disease management has become the focus of global attention.Diabetes as a common chronic disease,which seriously affects the physical and mental health of the whole people and restricts the development of social economy,plays an important role in the family of chronic diseases.Timely understanding of the medical insurance resources utilization and medical quality level of diabetes has important reference value for the implementation of chronic disease prevention and treatment policy and the formulation of medical insurance policy in China.Therefore,this research aims to study a public hospital in Guangzhou City,the diabetes health care costs and medical quality index data,understand the basic situation of health care costs in patients with type 2 diabetes,to evaluate medical service quality in patients with type 2 diabetes in hospitalized Medicare and rural residents,standardize the medical behavior under the premise of rationality,preliminary study of type 2 diabetes mellitus urban and rural residents medical insurance rating standards,the overall standard of diagnosis and treatment behavior,strengthen urban and rural residents in Medicare inpatient cost management to provide reference data.Methods and ContentsA retrospective analysis of type 2 diabetes mellitus in a public hospital in Guangzhou during the past 2015-2017 years was conducted to understand the consumption of medical resources in type 2 diabetic patients.An expert team was set up to evaluate the rationality of the standardized behavior of hospitalization and the standard of hospitalization quota for hospitalized patients with type 2 diabetes mellitus based on relevant clinical guidelines and expert consensus.According to clinical path documents issued by national Ministry of health,combined with clinical experts,try to further improve the type 2 diabetes clinical pathway construction reasonable,assessment of disease status in type 2 diabetic patients admitted to the first set the table,continuous improvement of medical service quality.Results1.During the period of 2015-2017,the number of inpatients,total hospitalization expenses and per capita hospitalization cost of the patients with diabetes medical insurance in the public hospital increased gradually.2.After standardize the diagnosis and treatment behavior of patients with type 2 diabetes in urban and rural areas,the difference between the reasonable hospitalization expenses and the actual hospitalization expenses is statistically significant.The actual inpatient expenses of type 2 diabetes mellitus joined in rural and urban medical insurance system is higher than that of the rational analysis.3.The reasonable hospitalization expenses and the actual hospitalization expenses of the patients with type 2 diabetes were compared with the quota of the diabetes urban and rural residents' medical insurance,the difference were statistically significant.The actual hospitalization expenses is higher than the reasonable hospitalization expenses,which is higher than the hospitalization quota of medical insurance.Conclusion1.The diagnosis and treatment behavior of the medical insurance inpatients in urban and rural residents of type 2 diabetes is not standard,and it is necessary to further standardize the diagnosis and treatment behavior.2.The average cost norm of medical insurance for urban and rural residents with type 2 diabetes is relatively low,which can not meet the level of hospitalization expenses of patients with type 2 diabetes and urban and rural residents,and needs further improvement.Work PlanIn order to regulate the behavior of medical hospital,to provide "comprehensive,standardized and efficient" medical services,strengthen the comprehensive management of long-term diabetes extends to the grassroots hospital services,the next step in this research is to construct and implement clinical pathway for type 2 diabetes and diabetes disease assessment scale,improve the quality of medical treatment,diagnosed the disease state,the implementation of grading treatment system,to promote the effective use of medical resources in the area.