Effect Of Implementation Of DRGs Research In Jintan People’s Hospital

At present, the insurance coverage of Chinese three major basic medical insurances has increased to more than 90%. And it has nearly achieved full coverage. In the new healthcare reform, the payment method is not only related to the medical costs that can be effectively controlled, but also to the break even of the health insurance fund and the sustainable development of hospitals. DRGs system is one of the outcomes of Medicare payment reform. It controls total expenditures prepaid health care providers through the development of standards, so that the healthcare providers will bear the economic risk, effectively influences the health behavior, and controls rising health care costs to a certain extent.Thus, the welfare and fairness of public medical services will be better reflected. How to better implement DRGs and control medical costs reasonablely is of great significance to safeguard the interests of the patients, to improve operational efficiency of the medical insurance fund, to enhance protection of patients.Objective: To understand the effect and problems of the implementation of the payment methods, the present research mainly analyzed the economic operation of the hospital, the patient medicare compensation, medical costs, medical burden and drug costs of specific diseases and the impact on medical practices and medical quality before and after the implementation of DRGs in Jintan People’s Hospital.Method: This study used literatures collecting domestic and foreign papers about DRGs to provide theoretical guidance to design and survey implementation of this topic. We studied the behavior of Jintan People’s Hospital’s medical subjective and objective indicators, and compared medical expenses and compensation cases before and after the implementation of the hospital’s own disease payment, in-depthly analyse the effect of DRGs and the existing problems.Results:(1) Medicare patients cost burden has been significantly reduced;(2) The reform regulated medical practice to some extent, whereas maintained a generally good quality in health care;(3) The reform improved Hospital’s efficiency;(4) The refrom effectively reduced the refferal rate of patients-to sepcialists.Conclusions: The present study showed DRGs payment system had a overall good effect;(1) The patient’s medical burden has been significantly reduced;(2) Drug costs of the control is still a focus of the implementation of DRGs;(3) There are some problems in the implementation of DRGs and need to be improved.Recommendations:(1) Scientifically formulated DRGs payment standards;(2) To adjust the payment standard and to implement flexible management;(3) To improve the clinical pathway system;(4) Scientifically administer the clinical pathway system;(5) To increase supervision of medical institutions;(6) To improve information support policies;(7) To improve health care system;(8) To improve clinical utilization of proprietary Chinese medicines.