The Research Of Management Of Off-site Medical Treatment In Guangxi Urban And Rural Basic Medical Insurance

Background:health insurance as a social security system in one of the most important, is playing adjust the income gap, the role of social security and fair, but also in large measure contributed to the economic and social development and people’s health. Reform of Medical Insurance System in "wide coverage, covers basic, multi-level, sustainable" policy guidance progresses, study and solve medical insurance system, the size, structure, form how to achieve economic and social development and adaptation of modern problems. In recent years as increasing and improving the people’s health care needs of population movements, health care unbalanced allocation of resources have become increasingly prominent, remote medical acts occur more frequently, health insurance agencies medical billing and management in different places there is a big difficulty on how to carry out scientific and effective management of remote medical health insurance system become an urgent problem.Purpose:This paper aims to China and Guangxi urban and rural basic medical insurance for remote medical reform and development process of combing and objective analysis of the current situation and the management status quo of Guangxi urban and rural basic medical insurance for remote medical service reform, find Guangxi remote medical face problems and regulatory difficulties, combined with the reform of the experience of other countries and provinces, targeted solution put forward ideas and countermeasures.Methods:In this paper, literature research application research status across the country understand the history, development and status of remote medical reform and scholars in related fields; the use of expert consultation on the subject of design and other aspects of assessment and guidance; data collection methods collection 2011-2013 in Guangxi region’s urban and rural basic medical insurance for remote medical data using statistical analysis methods to collect the data processing analysis, combined with the use of a personal interview, the relevant managers structured interviews to collect the views of established policy reform difficulties existing in the reform and the reform of comments and suggestions, Dosing qualitative medical services and management of the status quo of Guangxi urban and rural basic medical insurance places an objective description.Results:2011-2013 off-site medical expenses total expenditure increasing year by year and growing fast, appropriate medical insurance schemes spending increased rapidly. Remote medical expenses to the main hospital costs and hospital expenses paid in an overall proportion of urban workers was higher than that of urban residents. In urban workers, the retiree medical costs were higher than off-site service personnel, medical flows mainly in the province. Medical insurance for urban residents who places a greater proportion of referral, and off-site and off-site emergency smaller proportion live. Medical insurance for urban workers, the relocation of retirement are the largest proportion, the number showing a declining trend; remote referral staff was increasing year by year, off-site and off-site emergency smaller proportion live. Supervision of the main problems are:lack of efficiency and fairness due to health insurance policy is not uniform; high cost and remote medical supervision more difficult, prone to moral hazard; the insured person reimbursement difficulties, longer reimbursement cycles, the financial burden is heavy.Policy recommendations:Measures related data analysis combined deal with the problems raised by remote medical treatment have to enhance problem solving ideas, promote equitable health insurance; the gradual integration of medical insurance system for urban and rural areas to achieve seamless health care system; continue to strengthen the medical insurance capacity and information technology to achieve social security card; establish and improve the national coordination mechanism to promote the provinces off-site medical billing facilitation; reasonable allocation of medical resources, and promote the equalization of urban and rural medical services.