Research On Cost Control And Quality Improvement Strategy Of A Hospital Under DIP Payment

Deepening the reform of medical insurance payment methods is an important policy deployment of the National Health Insurance Administration and an inherent requirement for the rational use of social insurance funds.DIP payments have a significant impact on the income of medical institutions,the internal management of medical institutions,patient satisfaction and information technology by overturning the previous traditional payment method of paying based on items with the aim of a win-win situation for medical insurance,hospitals and patients.DIP guides medical institutions in cost control and quality improvement,cost reduction and efficiency enhancement,and improves the level of refinement of hospital management while ensuring the sustainable use of social security funds and giving full play to its role in controlling medical costs and medical services.This paper,using Hospital A as an example,is based on DIP payment rules.It analyzes the current situation and shortcomings of Hospital A in terms of medical costs and service quality through case studies,comparisons with benchmark hospitals,and policy interpretation by the administration.The analysis of Hospital A shows that there are problems such as unreasonable structure,low operational efficiency and many defective events in medical cost,as well as problems in medical quality such as no clinical unified standard for treatment behavior,lagging quality management,insufficient diagnosis of rare illness and treatment,and non-excellent specialist ability.Problems are analyzed one by one,followed by suggestions for strategies to improve medical cost control,i.e.,to establish a closed-loop management mechanism for the whole process of medical consumables,to set up a plan for unreasonable tests and examinations according to project management,to reconstruct the admission and discharge process with a service blueprint,so as to realize "one bed" in the whole hospital.In addition,FMEA-based adverse event management should be used to create a medical safety culture.Methods such as optimization of clinical pathways by PDCA cycle,construction of large disciplines with the help of integrated thinking,and upgrading of specialty service capacity are used in improving the quality of medical services.In this paper,the current situation and problems of Hospital A in cost control and quality improvement are analyzed through data mining,together with the policy background and treatment principles,to explore and study the coping strategies that meet the actual situation of Hospital A.Thus,it assists Hospital A in cost control and quality improvement and refines management.It is of reference for the sandwich-level municipal hospitals that are below the same benchmark hospitals and above the county-level hospitals that are suffering from no way to improve.