The Study On The Compensation Mechanism Based On The Reform Of Public Hospital In Military Hospital

ObjectiveThe compensation mechanism in public hospitals is the key and core of China's Health Reform.Military Hospitals,as special public hospitals,should comply with health care reform policy.But there is no compensation mechanism policy for the military hospitals,which forcing the military hospitals must find their own ways.In the context of reform of public hospitals under the compensation mechanism,this study using the face to face interviews of medical staffs in two military hospitals,questionnaire of patients in four military hospitals,and interview Medical Information with one of the Military Hospital.Collation and analysis of data,then proposed military hospital fees and compensation mechanisms for enforcement measures.To provide the theoretical basis and data support for the normal operation,sustainable development and reform designed of military hospitals under the new medical reform.Data and Methods1.Materials resources: The policy documents and research literatures respectively rooted in web searches,and electronic journal database.The interviews and questionnaire data respectively derived from 20 medical staffs in two military hospitals and 283 patients in four military hospitals.The medical service information from 1st July,2010 to 30 th June,2013 was extracted from the military health system NO.1 of one military hospital.2.Research method: Firstly,the interview outline and questionnaire were designed on the basis of theoretical analyses and comprehensive reviews;Secondly,the face to face interviews and field investigation were conducted to collect and analyze the related information and data with Epidata3.1 and Spss18.0;Thirdly,the extracted entire data and its constitute parameters of medical service information in one military hospital were analyzed with Excel 2007 and SAS9.2 statistical software;Lastly,the corresponding expense compensation mechanisms of military hospitals were discussed with the comparison analysis method.Results1.The face to face interviews found that the all medical staffs in one military hospital agreed with the policy of “canceling drugs addition”,but they considered that would decrease the incomes of military hospitals and service levels for troops,resulting in future loss of army and non-military talent and influencing the whole development of military hospitals.2.The questionnaire data indicated that the drug expenses accounted for more than seventy percent of outpatient expenses.Patients worried that there will be an increase in the other expenses after canceling drugs addition.Above seven in ten patients accepted the new outpatient charge standard,which would increase the outpatient amounts of chief physician and renowned experts.Nearly four in ten patients still thought drug price is high and feel cant't understand and helpless.3.The medical information revealed that the outpatient and inpatient were respectively 91.7%(2105182)and 8.3%(189848)of in one military hospital,and the 84.3% of total was non-military patients.In the medical incomes of opening to the society,the incomes of drug and medical services respectively accounted for 39.3% and 60.7%.The drug proportion decreased year by year,and the incomes of drug dropped is more than medical services increased.The incomes of examination,test,therapy and material accounted a higher percentage in medical services incomes.In the outpatient service of opening to the society,the percentages of person-time and expense of self-paying patient were the highest with respectively 60.8% and 57.9%.The medical expense per time was higher than tertiary hospitals.The total medical incomes increased year by year,the incomes of drug and medical services respectively accounted for 48.6% and 51.4%.In the inpatient service of opening to the society,total person-times firstly increased and then decreased with the 89.3% is non-military patients and 50.5% is self-paying patient,and non-military patients with insurance accounted for up to 38.8%.The inpatient incomes firstly increased and then decreased,the average hospitalization days and expenses decreased year by year and hospitalization expenses per day per bed decreased year by year.The incomes of drug and medical services respectively accounted for 37.5% and 62.5%.The incomes of material in medical services incomes was the highest,then the examination and therapy.Drug expenditure of total expenditure was the highest(49.7%),followed by material expenses(28.7%).The subsidy of performance and salary accounted for 62.4% and 17.9% of human cost.Conclusion and recommendationsCurrent medical expense compensations of military hospitals existed some main problems including lacking of local government compensation,unreasonable medical service price system,imperfect compensation mechanism of medical insurance,the loss of military talent,and serious delay of compensation measures and so on.In order to promote the perfection of military hospitals compensation mechanism in China,the policy should adjust with medical amount,based on the local conditions.The compensation should be implemented individual.The operating costs should set up by adding the pharmaceutical service fee and strictly controlling the hospital procurement.The current system of medical insurance payment should be improved.The supervision of compensation mechanism should be strengthened,and reducing the burden on patients.Developing the compensation measures for staff appointment system timely,at the same time,strengthen publicity and strong supervision of the relevant policies...