The Total Prepaid In The Implementation Of Four Public Hospital For Chinese Medicine Research

Background and Objective: In recent years,with the improvement of medical security system, and strengthening national health investment, the problem of difficulty and high cost of treatment has been preliminary relief, but the pressure of medical insurance fund is increasing quickly. To control the too fast rising medical expense and reduce pressure, our country began to explore various forms of payment of medical insurance fund, which of them is Prospective payment of total amount money system. It encourages the supplier of medical services that charged fees initiatively. So it gets the nation’s support. This article mainly through four areas research, which include four public TCM hospital located in the Shanghai, Henan, Gansu and Beijing, investigate the implementation of prospective payment of total amount money system in the four public TCM hospital, in order to understand the relative issues and its influence, then put forward related suggestions,provide the reference to the execution of the system and make decision for the government.Methods:This study mainly use literature analysis and interview the head of management of TCM, the director of medical insurance department by telephone, to understand the implementation of prospective payment of total amount money system,then combine with literature analysis,questionnaires, interviews with experts and On-the-spot investigation, to collect the information of the four hospitals that is used to analysis and research.Results:Government formulate sensible policys, hospitals also make measures and perform the assessment of medical insurance department, it has controlled the too fast rising medical expense. The four hospitals adopt the same way of calculation and prospective payment, But some respects such as measuring range, the calculation of indicators, supervision measures and examination is different, the measures and proportion of sharing have differences, and the four hospitals all appear different degrees of that actual situation exceed budget in the implementation of the system, insufficiency of sharing, and the hospital undertake too much pressureConclusion:The Prospective payment of total amount money system has generated positive effect, at the same time it has some negative influence. The medical insurance policy and the management of hospitals in some areas does not reach the designated position, four hospitals occur a series of problems,such as the measure is inaccurate, overruns, insufficiency of sharing, the hospital’ pressure is too much, and enthusiasm of service is affected. Therefore the insurance departments need comprehensive consideration of various factors,determine the total amount money of prospective payment, improve the system; the three parties including patients, hospitals, insurance department need to cooperate with each other, enhance the level of hospital management, the implementation of the sharing policy, enhance the consciousness of patients to save medical insurance costs; At the same time improve the inspection and supervision. Through the measures, promote the prospective payment of total amount money system playing a posive role and promote it more effective implementation in hospitals of TCM.