Impact Analysis Of Operating Model Of Tertiary Hospital Departments Under Total Prepaid System

Object: The new health care reform of nation requires Medicare payment reform and improvesuniversal health care system. A region of Xinjiang Production and Construction Corpsimplemented total Medicare prepaid payment in January1,2013. Clinical departments are majorinstitutions of implementing operations management policies of hospital. This study aimed toinvestigate and analyze the changes of a medical and a surgical before and after theimplementation of a total prepayment of quality of care, medical expenses, economic operatingconditions, cognitive and medical practices of medical personnel. Investigate the effects of Thetotal prepaid system to a tertiary hospital departments operating mode. Provide reference for totalprepayment system operators in three hospital departments, provide recommendations for researchand implementation of the total prepaid system.Methods: Literature research and expert interviews are used to drawn the director interviewoutline in this study. We established cognitive and behavioral health questionnaire of the totalprepaid system. Contrast Changes of2013of urology and Endocrinology and Metabolism of atertiary hospital three years before their quality of care, medical costs, economic operators,patients source and other aspects. Using gray relational analysis to analyze diabetes hospital costsof Endocrinology and Metabolism of2010-2013.Explore the total impact on the departmentprepaid business model according to various policy and data.Results: Number of hospitalizations, average length of stay and bed occupancy rate ofEndocrinology and Metabolism and Urology has declined, outpatient visits increased. The totalhospital costs, the average hospital costs and the proportion of drug of Endocrinology andMetabolism has declined. The total hospital costs and the proportion of drug of Urology hasdeclined, but the average hospital costs has rised. Total revenue growth, revenue growth ofmedical, pharmaceutical, and total spending growth rate of two clinical departments has declined.Fewer patients sources of Endocrinology and Metabolism changes, increased urology patientssources outside Shihezi. Analyze the results of total prepaid system of diabetes, the cost levels of2013is lower than2011and2012, higher than2010. Medical personnel lack cognitive to totalprepaid system, over half medical personnel have the negative attitude.Conclusion: According to contrasting Changes of urology and Endocrinology and Metabolism ofa tertiary hospital three years before their quality of care, medical costs, economic operators,patients source and other aspects after implementing total prepaid system, we put forward thefollowing suggestions: first, estimating departments indicators legitimately, building a scientificmodel of health care allocation; secondly,strengthening information technology, monitoringMedicare data real-time; thirdly,improving the performance appraisal system, establishingincentive and restraint mechanisms; the fourth,understanding the health insurance policy in-depth, forming a unified understanding; the fifth, for den grenzgebieten, the implementation of compositepayment under total prepaid system is a practical way of achieving a win-win economic and socialbenefit of hospital clinical departments.