Research Of Diabetes Capitation Payment Reform's Influence On Hospital Management

In recent years, the problem of expensive medical treatment has been Chinese people's major livelihood issues. It is not only concerned about our daily life, but also affects the sustainable development of the health insurance fund balance of payments, the doctor-patient relationship, and hospital management. At present, China's medical payment is still dominated by the way of fee for services, that is to say,the patients see the doctors in accordance with the agreed medical services, medical institutions providing medical services first, and insurance institutions and individuals paying after the services.This "pay-after-service" mode prone to induce excessive medical behaviors, and the patients have to exhaust itself to great economic pressure. To effectively control health care costs, and make ensure people see doctors with less fees, Tianjin Human Resources and Social Security Bureau has launched the reform of governmental medical payment ways, and proposed the implementation of capitation payment for a specific disease called diabetes in Tianjin. In this system, people can feel free to treat, give full play to "fund gatekeepers" and "healthy gatekeeper" role of the doctor in order to achieve the goal of medical expenses control and medical quality assurance. In this paper, Tianjin capitation payment reform is an opportunity to further examine the hospital management changes under capitation payment. The ST hospital was the reform pilot site selected by Tianjin Human Resources and Social Security Bureau. After research on the ST hospital, we found that the change of medical payment can indeed promote continuous improvement of hospital management, and promote the continuous improvement of hospital efficiency, strengthen information technology. The management changes are mainly reflected in cost management, performance appraisal, process management, training management and information management. Meanwhile, there are also some problems in the reform, such as publicity is not in place, the information platform constructions lag, lack of human resources and so on. This paper focuses on the problems of cost management, and found that under capitation payment medical expenses decrease monthly, health care costs are under control, physician performance assessments are significant. However, if based on the assumption of the cost standards, cost control aim implementation is notoptimistic.Finally, according to research and literature studies the paper proposed some suggestions, such as the overall planning, paying attention to detail, strengthening the integration of information platform, focusing on the role of community hospitals, strengthening the scientific determination of medical expenses, according to different circumstances and patient level to cure patients and pay the fees, promoting different kinds of medical payments coexist.