The Present Condition And Evaluation Of Henan Experimental Diseases Related To Groups

Objectives(1) With scientific theory as guidance,to study the influence indices for the medical service quality and analyze the changes of medical service quality and the influencing factors;(2) To analyze the patient satisfaction and the influencing factors.(3) Through the investigation of medical and health institutions,medical service provider(staff) and medical service consumers(patients),to undeestand the present condition of DRGs payment reform and the reactions of the above three.(4) To evaluate the effects of the DRGs medical service,mainly on medical service quality,also the cost of medical service.It can provide valuable reference for medical insurance institutions.Methods(1) Using the current research methods,the Henan DRGs experimental units are random sampled,the staff and patient were investigated using self-designed questionnaire.Using the descriptive technique,to analyze the influence to the hospital administrators,medical personnel and the doctor-patient relationship. (2) Based on the Chen Pingyan's Impatient Satisfaction Questionnaire,the self-designed questionnaire is designed according to the certain purpose.(3) All the clinical cases are simple random sampled,by using statistic description of the average day in hospital,the total fees and drug fee to do the association studies. SPSS12.0 was applied to analyzing the data,data input was applied by Foxpro6.0.ResultsIn the Henan experimental unit,the amount and sorts of disease is large in ClassⅠand ClassⅡ,the amount and sorts of disease is small in ClassⅢand ClassⅣ.Different medical personnels have different opinions on the DRGs reform,This is mainly because they have different posts.Referring to waiting times and satisfaction with security assurances,in different sub-items,the different patients' satisfactory is different.Various operation patients have only one differences of a subkey.It is obvious that DRGs management patients score significantly higher than the project management of patients(P＜0.01).According to the structural comparison and statistical analysis of second-class hospitals and third-class hospitals,the systematic sampling results show that:the overall length of stay in the second-class hospitals is more than 15.00%on average than that of third-class hospitals,which is still in a relatively reasonable level;from the total cost of hospitalization,the third-class hospitals generally keep average higher of 12.00%than second-class hospitals,which reflects natural differences of level,technology,equipment and hardware;the drug costs of the second-class hospitals are significantly higher than those of second-class hospitals,an average of 17.00%,reflecting that the second-class hospitals use more drugs in the provision of essentially the same medical services.ConclusionsThe pilot of Diagnosis Related Group works smoothly in Henan Province,to a certain extent controlling the substantial increase in medical costs.But in majority of provincial hospitals and specialist hospitals,it is not satisfactory to carry out.The implementation of payment by the disease must be based on the work of a large number of prerequisites.First of all,it can effectively control the unreasonable part of medical expenses from the diagnosis,examination,treatment cost,which is conducive to control and save costs.Furthermore,medical institutions can be encouraged to strengthen the medical quality management,improve the diagnosis and treatment to promote advances in medical technology.Meanwhile,it can establish and improve the promotion of hospital cost accounting system in order to reduce operating costs.Last but not the least,it can be able to ease the tension between doctors and patients,since the broad masses of people hold a positive attitude to paying according to disease.