Analysis On The Implementation Effect Of The Global Budget In New Rural Co-operative Medical System In Yanliang District Of Xi'an

New Rural Co-operative Medical System has achieved significant success since it implemented in 2003, and farmers have more guarantee for medical treatment than before, level of medical care has also been significantly improved. However, rapid rise in health care costs made this system's advantages shrink, to some extent, although compensation reimbursement level increased year by year, still far behind the rising rate of health care costs, and thus farmers still cannot afford the high expense in health care. For the reason of this phenomenon, except some object reasons such as inflation and advance in medical technology, the real reason is the traditional payment method--pay by project. Pay by project is a kind of payment method which may stimulate medical institution to increase treatment's cost constantly, and prolonged the day in hospital, even more, add some treatments which are unnecessary. Therefore, executing payment reform is the only way to control the medical costs.Yanliang District in Xi'an implemented global budget in the third season of 2012, and launched a pilot project in Yanliang District People's Hospital, and generalized in 2014. This paper is based on the actual data during operation which were got by the field investigation. Then analyze the proformance of the global budget in Yanliang district, and try to provide reference in the progress of Xi'an's payment reform in both practical and theoretical. In this paper, the author use a series of indications to measure the proformance of global budget in Yanliang, these indications are which can indicates the change of medical cost since global budget is implemented, which can measure how the hospital handle the risks in this payment system, and which can tell the patient satisfaction, and also choose some typical illness as assessment index to analyze the global budget's work. After the data analysis, it found that the global budget in Yanliang district is comparatively success for the reason that the medical cost has been under control. However, the author also found some problems in policy formulation, risk control and fund measurement, and then offer some suggestions to solve such problems. such as cancel special cases generally, change the key points of insurance agency, calculate the fund by CPI, etc. Finally, make a general evaluation of global budget in Yanliang district in Xi'an, and try to support the improvement of global budget.