Study On Medical Expenses Of The NRCMS' Inpatients In Country Medical Service Community

Objective:To understand the policy background and specific measures of the medical community in Tianchang city,Anhui province.To analysis of the mechanism and effect of the medical expenses control of the NRCMS' inpatients in Tianchang county.To explore the condition of the medical expenses control of the NRCMS' inpatients based on the Capitation in tianchang city,providing reference for other areas to control medical expenses.Contents:1.The background of the reform of the county medical community in Tianchang.2.Specific measures for the reform of the county medical community in Tianchang.3.Mechanism of medical expenses control for inpatients under new rural cooperative medical system in Tianchang County.4·Effectiveness of medical expenses control of inpatients under new rural cooperative medical system in Tianchang County.Methods:This study used literature research to review the theoretical basis of medical expenses.To demonstrate the rationality,effectiveness and availability of analytical indicators by consulting with experts in the fields of health policy,health economy,as well as officials of the health administration department.The data collected through the text survey and field investigation,using system dynamics analysis the control mechanismin of Tianchang medical community and the reform measures for health care payment to medical expense control in Tianchang city,Anhui province based on the CIMO framework.Results:1.The stakeholders related to medical expenses control in Tianchang city mainly includes the government department,the department of health care insruance,medical and health services institutions,doctors and patients,and all the stakeholders' behavior choice together influence the change of the medical expenses.2.From the analysis of system dynamics,it can be seen that reasonable and effective payment method and differential reimbursement ratio have an incentive and restraint effect on the behavior of both supply and demand.The help mechanism of county-level hospitals to township hospitals has strengthened the service capacity of the primary medical institutions,and the two core measures have been combined to increase the rate of consultation at the primary medical institution,control the medical costs and save the medical expenses.3.The path of medical treatment costs in Tianchang city has both external policies and measures,the attractive of health insurance,primary medical institution support and technical support,as well as the intrinsic value and power consumption of medical institutions.4.The effects of medical expenses control in Tianchang city:after the reform of the medical community,the medical expenses are effectively controlled and the patient burden is further reduced;Health care funds run more efficiently.Conclusions:Under the mode of the medical community in Tianchang county,the reform of the medical insurance payment method based on the Capitation is used as leverage to strengthen the communication and cooperation between medical institutions,to change the doctors' microscopic diagnosis and treatment behaviors and patients' medical treatment,to control the moral hazard of both sides,and play a key role in the control of medical expenses.Recommendations:1.Build a long-term mechanism to control unreasonable growth of medical expenses;2.Strengthen the health management system and control the growth of medical expenses from the source;3.Increase the awareness of patients' control fee,so that they can actively participate in tiered health care system;4.Supporting other reform measures to jointly control the unreasonable growth of medical expenses.