| Objectives:By collecting the data of county hospitals in Xining city, to describe and analyze the current situation and economic operation situation of financial investment of 6 county hospitals in Xining city, analyzing of the financial investment mechanism of county hospitals in Xining city, analyzing the incentive mechanism, restraint mechanism and supervision mechanism of the financial investment mechanism of County hospitals, to provide reference for the establishment and improvement of the financial investment mechanism of county hospitals in the western region in China.Methods:This paper mainly used empirical case study method. Using qualitative analysis and quantitative analysis to analyzing the current situation and financial investment mechanism of county hospitals in Xining, and revealing the mechanism of how to encourage, restrain and supervise the financial investment in County hospitals.Results:1.The financial input in county hospitals in Xining city status:(1) Financial direct input to county-level hospitals:Financial direct subsidies amount to public hospitals at the county level and account for hospital income showed a trend of growth from 2012 to 2014. The financial input amount and financial direct investment of the hospitals accounted for the proportion of hospital income was largely different, the financial investment accounted for hospital income nearly 30%. Compared with the level of financial investment in county hospitals in China, the level of financial direct investment to county hospitals in Xining was higher than that in china. Three counties public finance to the county hospital’s subsidy mainly for basic subsidy expenditure. Financial subsidies to the county hospital mainly for basic grants, which mainly accounted for the personnel funding. (2) The indirect investment of finance to the hospitals:County hospitals medical income of the medical insurance fund for the new rural cooperative medical fund.90% of the new rural cooperative funds from the central government and local governments at all levels of finance, about 10% from the individual contributions. Financial subsidies accounted for the three major health insurance fund about 80%-90%. Health insurance revenue accounted for about 60% of the hospital’s medical income. Three large financial subsidies accounted for 60%-70% of the hospital’s total income. Medicare overall expenditure is mainly used for hospital expenses. The cost of the new rural cooperative fund is mainly used for provincial hospitals and county hospitals, accounting for almost half of the total. Expense mainly occurred in provincial hospitals and county hospitals.2. Economic operation status of county hospitals in Xining:(1) The overall situation of economic operation of county hospital:small scale, large population density and the relationship between counties. County hospitals are small business size and are at a loss, in the financial aid was barely flat. The assets of the county hospitals in Datong County and Huangyuan county were improved. The operation efficiency of county hospitals is better. Xining county hospital costs a little higher than the average level of Qinghai Province, and increased year by year. (2) Income expenditure analysis:the county hospital business income of traditional Chinese medicine income accounted for nearly 50%. The cost of traditional Chinese medicine at the county hospital costs about 46%, second are staff costs, accounting for about 31%. The business income and expenditure of the county hospital is generally at a loss. Drag expenditure in county hospitals after the implementation of zero drug policy is in a state of loss. Nursing income cannot cover the cost of care.Conclusions:1.The financial subsidy to the county public hospitals in Xining city was large. 2.The direct financial subsidy to the hospitals of Xining was mainly used for "raising people", and the financial incentive and restraint mechanism was weakened; after the implementation of "drug zero addition "policy, the financial subsidy to the county public hospitals was still based on drug revenue, lacking the effective restraint mechanism; county hospitals’ reimbursement amount was low, under the Medicare reimbursement controlling total amount policy, county hospital refused series illness but medical costs were not low.3. Financial investment mechanism of county hospitals in Xining.4.Xining can learn from the "award on behalf of the" performance evaluation of the practice of experience of Zhenjiang City, change the Subsidy methods based on the amount to the performance; draw lessons from Zhenjiang’s budget management restraint mechanism based on total cost accounting; Learn from the payment methods reform in Zhenjiang, change the total amount to the total budget. |
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