Research On The Effect Of The Total Prepaid System About Hospitalization In Haiyuan And Yanchi, Ningxia

Objective: we have adopted the method of health economics, taken the consideration of all interests of multiple stakeholders, and comprehensively summarized the effect of this total prepaid system system implementation in yanchi and haiyuan, compared the difference between before and after project implementation, and further learned the the successful experience and disadvantages about this total prepaid system system.All what we have done make us play a important part in the county hospital "gatekeeper",and give some evidence and suggestions to perfect the scheme.Finally, we can Promote this system reasonable and sustainable development, provide scientific basis for government decision-making.Methods: In order to understand the basic operation information of total medical budget of hospitalization, we collected data files from health care centers and medical institutions of county, key figures interviews Through questionnaire.We analysis the data collected by applying SPSS and excel software to, and then evaluate the effect of this system. Main indicators are hospitals the patients choose, the influence of this total prepaid system on the demanded, and the influence of this total prepaid system system on the provided..Results: 1.The rate of the participating in this new rural cooperative medical system( NCMS) of this two countries in 2009-2013 is high,more than 90%. And the funds of new rural cooperative medical system have balance.2. The data shows that the funds was overspended in 2009-2013,but the stability comes up after the total prepaid system implementation.3. From 2012 to 2014, haiyuan hospital patient proportion is 66.55%, 64.54% and 66.55% respectively,and the same proportion is 78.64%、83.24%、86.19% in yanchi, both results showed a trend that the patients are more likely to go to the hospital of country after this system. 4. From 2012 to 2014 the total health costs of haiyuan accounted for 45.78%、51.53%、56.62% among which patients don’t have to pay 56.13%, 59.84%, 64.92% by themselves. From 2011 to 2013, the total health costs of yanchi accounted for 45.78%、51.53%、56.62% among which patients don’t have to pay 56.13%, 59.84%, 64.92% by themselves. All indicators showed health expense proportion which don’t pay themselves was becoming more and more year by year.5. The residents of haiyuan who have join the total prepaid system need to spend 2592.87 yuan, 2900.09 yuan and 2866.32 yuan by themselves respectively from 2012-2014,the datas about all expenses have decreased since 2013.The same to the yanchi country,in 2011-2013,the residents of yanchi need to spend 2833.14 yuan、2344.23 yuan、1800.9 yuan, all expenses have decreased year by year.6. Ninghxia 2012-2014, county hospital and the hospital in hospital medical institutions at the county level in the annual growth rate on the rise, building hospital annual growth rate is on the decline.The rate of country hospitalization have increased in haiyuan since 2012-2014.As a result,the hospitalization in ninghai decreased,but the rate of yanchi country Hospitalization increased.7. The hospitalization costs and days of the same disease in country hospitals increased except for ninhai hospital.8. Female medical staff in haiyuan country hospital has a more proportion than male staff, accounting for 66.08%;the proportion of young staff who are under the age of 45 is 89.86%; 90.91%of the staff have college degree or above. Generally speaking,they have high degree rate.9. 77.62% medical staff in haiyuan country hospital feel the stress after the implementation of this the total prepaid system.And they have to improve their ability to treat.10. 80% medical staff in haiyuan country hospital think that this the total prepaid system can solve the main problem existing in hospital to some degree.Conclusion: 1. The number of country Hospitalization has increased year by year.It proved that the total prepaid system t has Achieved a good effect in the beginning.2. Although the proportion of the total health expenses which is the cost of outside the county hospital is down, and maintaining and reducing the proportion still have challenges.3. All costs continue to rise in County hospital,and at the same time, the medical behavior needs to be regularized.4. The hospitalization costs and days of the same disease in country hospitals has not been effectively controlled, the county medical institutions need to strengthen management.5. Medical staff at the county level after the system pressure, efforts to adapt to the new medical environment for further study.The medical staff should make their effort to have a further study to adapt to the stress brought by this system.6. Medical staff of the country hospital have a need to improve their understanding this system, and medical institutions should strengthen the training. Recommendations: 1. Keep on conduct more propagandae about this the total prepaid system to attract more patients returning to the country hospital to be treated. 2. Medical institutions at the county level should improve their own management and training, regular medical behavior of their personnel.3. Medical institutions at the county level should motivate their staff and make them familiar with the specific content of the the total prepaid system4. Strengthen the cooperation between health care centers and hospitals, and insure the total prepaid system successfully carried out.5. The medical staff Should improve their ability of all kinds by using this total prepaid system to promote and provide training opportunities.