Research On The Behavior Patterns Of Shanghai Public Hospitals Under Global Budget Mode

China's total health expenditure growth has exceeded GDP growth,while personal health expenditure accounted for the total costs also surplus the warning line.The "expensive medical expense" as a crucial social problem is ready to solve.The new health care reform has promulgated in 2009,which suggests using a new medical expense control method,called Global Budget,known as the most effective medical expenses controller.Shanghai has applied the method in 2002 and accumulated over ten years of experience.This paper studies the main public hospital in Shanghai and then uses literature review,quantitative analysis to find the key factors in its behavior model.In the FFS stage,the model uses the assumption of rational economic,to build public hospitals and patient game,concluded that public hospitals to take reasonable or excessive medical acts relatively to the economic level of the patients;Game Model of public hospitals and medical institutions indicated a quantitative formulas which demonstrates reasonable medical probability in public hospitals and regulatory costs are negatively correlated,and negative social cost of losses and penalties are positively correlated with for excessive medical hospital medical institutions.In the global budget stage,the model uses rational economic hypothesis,conclude that : public hospitals to take reasonable or excessive medical acts associated with the severity of the patient;reasonable medical probability that public hospitals are also services paid by the three elements of the relevant stage;moreover,adding budget game of public hospitals and medical institutions obtained that public hospitals need to improve internal system to achieve balance in order to achieve and medical institutions for the Nash equilibrium of budget.From the macro and micro dimensions,Shanghai Insurance and 14 comprehensive public hospitals runs well after applying Global Budget.Through the model equation and case data,it is concluded that the Global Budget method plays an important role in the health care expenditure control of public hospitals in Shanghai.However,some problems also arise,such as the increase of patient's own expense.Finally,this paper makes some recommendations for the Global Budget system of public hospitals to improve its effectiveness in running this system.