Research On The Reform Of Medical Insurance Payment Based On Medical Cost Control

The problem of "expensive and difficult to see a doctor" is one of the most important concerns of people.In order to solve the people "see a doctor" difficulty and high cost problems,our country has adopted a series of measures such as "the integration of urban and rural residents health care payment,health care reform,to set up the classification diagnosis and treatment system,construction of couplet of medical".However,the total health expenses relative to the economic development of our country present excessive growth,medical services gradually increasing,per capita health expenditure relative to the per capita disposable income growth is too fast,this is beyond economic growth cost burden is borne by the people,which is formed by the.The increase of medical expenses is a hot issue of social concern nowadays.The excessive medical expenses inhibit the use of outpatient and inpatient services,and the health of our people must be suppressed.As an effective measure to deepen the reform of public hospitals and control the excessively rapid growth of medical expenses,the reform of medical insurance payment method has been taken seriously by the state.Therefore,it is necessary to study the status quo and existing problems of the reform of medical insurance payment.The research content mainly includes five parts:the first part is the foreword,and this part mainly includes the research background,the research status,the research content and the research method and the innovation of the research.The second part is the theoretical basis of the reform of medical insurance payment and the reasons for the increase of medical expenses.First of all,this paper introduces the definition and advantages and disadvantages of each payment,secondly,according to related theory of medical insurance payment reform,in the final analysis the reason of the medical expense growth,interpretation of the "medical institutions,insurance," tripartite behavior impact on health care costs.The third part is the status quo and existing problems of the reform of medical insurance payment in Shandong province.This paper analyzes the present situation of the reform of the medical insurance payment method in the county-level public hospitals in Shandong province,combines the empirical analysis with the theoretical analysis,and analyzes the existing problems and causes of the reform of medical insurance payment in Shandong province.The fourth part is the reform experience of medical insurance payment at home and abroad.Abroad from the United States and Germany,the domestic has chosen places such as gansu and Huaian,the Medicare payment reform experience of both home and abroad are introduced and compared in Shandong province medical insurance payment reform the existing problems and put forward the experience for reference.The fifth part is the policy suggestion to deepen the reform of medical insurance payment.On the basis of the above theory and empirical research,to control the unreasonable increase of medical expenses,promote the reform of health insurance payment in our country smoothly implementation,put forward policy Suggestions.It is proposed that our country must transform the current single payment method,implement clinical pathway management,reasonably expand the number of disease types paid by disease category,explore DRGs,implement payment according to disease category scores,and play a positive guiding role of payment methods for medical institutions.The reasonable control fee is realized through the reform of payment method.