| With the rapid development of our country's social economy,the people's demand for medical and health services has been increasing,especially the inpatients are paying more and more attention to the related expenses.Under this background,China has implemented a new round of reform of the medical and health system,and the construction of medical association has been promoted to a national level policy.The management mode of medical association in Z city of Jiangsu province is divided into tight management mode and loose management mode.Each mode is led by a core hospital.A hospital is the core hospital of the tight management model,and B hospital is the core hospital of the loose management model.The purpose of this study is to analyze the cost difference and the influencing factors of some diseases in the core hospitals of the medical association under different management models,and to indirectly verify the implementation of the medical insurance policy and the effect of cost control in the core hospitals under the two management models.For other regions to choose which type of medical association management as a reference.The results showed that there was no statistically significant difference between the two core hospital samples in terms of age,gender,marriage,occupation,and payment category(P>0.05),indicating that the sample selection is comparable.There is a statistically significant difference between the two core hospital samples in terms of surgical treatment and the number of days spent in hospital(P<0.05).Through a retrospective survey of the hospitalization costs and demographic characteristics of some types of core hospital diseases under different medical conjoined management models in Z City,Jiangsu Province from 2014 to 2016.A hospital investigated 2025 cases of coronary heart disease,353 cases of acute appendicitis,and 714 cases of mixed hemorrhoids.B hospital investigated 1391 cases of coronary heart disease,328 cases of acute appendicitis,and 1024 cases of mixed hemorrhoids.In terms of the average hospitalization cost and the average number ofdays of hospitalization,the per capita hospitalization cost of acute appendicitis in hospital A was 7908.52 yuan,and the average number of days of hospitalization was 7days;The per capita hospitalization cost of coronary heart disease was 17026.23 yuan,and the average number of hospital days was 11 days;The per capita hospitalization cost of mixed hemorrhoids is 9898.85 yuan,and the average number of days of hospitalization is 9 days.The average hospitalization costs and hospitalization days for the three diseases in Hospital A were significantly lower than those in Hospital B(P<0.05).The cost composition ratio was not significantly different between the analysis group and the examination fee,operation cost,and treatment fee.However,there was a significant difference between the material fee and the drug fee and other fees,and the A hospital was significantly lower than the B hospital,which was statistically significant(P<0.05).From 2014 to 2016,the average hospitalization costs for coronary heart disease,acute appendicitis,and mixed hemorrhoids all increased year by year,and there was a statistically significant difference in average hospital costs between years(P< 0.05).The study found that in recent years,the average hospitalization costs for patients with coronary heart disease,acute appendicitis,and mixed hemorrhoids have been increasing year by year.Among them,the average hospitalization costs for patients with three diseases in hospital A are lower than those in hospital B.In vivo medical insurance policy guidance and cost control are more effective.It is suggested that the construction of a close-connected medical intermediaries should be given priority in the reform of the medical associations in other regions.At the same time,the government should play a leading role in strengthening the publicity of the medical association and the supervision and management of public hospitals. |
PDF Full Text Request