Research On Pricing Mechanism Of Medical Service Based On Public Welfare

Objective: In view of the existing problem of the medical service price system in our country,around the "public hospital public welfare",further straighten out the practice of the medical service price comparison relations for the government to provide guidance,the medical service pricing can better reflect public welfare provides a new way of thinking.Methods:To sums up the existing literature,at the same time,combined with expert interview method,according to the opinions of the experts interviews to survey need to be improved along with the questionnaire of perfect,the preliminary plan expert consultation questionnaire;Through three rounds of expert consultation method,respectively in the health services of medical standards,the living strength,classifying medical service project indicators,on the basis of complete classification to develop different pricing principle;Use expert,extent of authority and active coefficient coordination coefficient to illustrate the science of medical services index classification and reliability;Using SPSS21.0 software,using t test to investigate the analysis with the traditional invasive surgery in the operating room during endoscopy surgery fee structure,thus further reflect the status of the current medical service price comparison relations.Results : After three rounds of expert consultation,medical services for the project,respectively,medical guidelines rigid,live labor intensity to complete the classification of the 43 level indicators.The positive coefficients of the three wheeled experts were97.44%,94.06%,100%,respectively.The authority of experts is 0.8490.Expert coordination coefficient of the first round of expert consultation in medical standards and labor intensity rigidity were 0.626(c 2=985.428,P<0.001)and 0.431(c 2=670.353,P<0.001);expert coordination coefficient index of the second round of expert consultation of medical standards and living rigid labor intensity is divided into 0.597(X~2=998.125,P<0.001)and 0.527(X~2=650.218,P<0.001);expert coordination coefficient index in the third round of expert consultation in medical standards and living rigid labor intensity is divided into 0.538(X~2=1028.511,P<0.001)and 0.460(X~2=636.947,P<0.001).In addition,based on the submitted common surgical operating expenses and structure were analyzed,and compared with before the medical service price adjustment,in Qingdao city medical service price adjustment in the total cost of the operating room,after surgery,anesthesia fee and other technical service fee has increased,and from the point of cost structure,the composition of technical service fee is larger than rise,and the cost of a one-time consumables and is markedly reduced the proportion of operating costs,in addition,inspection,monitoring is also fell slightly.However,one-time consumables fee,inspection,monitoring,such as unskilled labor and its proportion is still significantly higher than the technical service fee,the fee for one-time consumables in the most significant.Conclusion : Under the prerequisite of the reality of project fee,it is beneficial to construct the economic space for medical service projects with strong medical standards,which is helpful to motivate the public welfare behavior of medical service providers;for medical service projects with weak medical standards and free choice of doctors for narrow profit space,and even equal to or less than the cost of pricing,can effectively guide the medical service provider to the patients as the center,according to medical needs,rather than according to the economic interests of public welfare behavior;The adjustment of medical service prices while further straighten out the relationship between the medical service price,but about medical personnel technical services has yet to be further reasonable value.