Analysis On The Linkage Reform Of Medical Insurance And Hierarchical Diagnosis And Treatment System

In 2009,China carried out a new round of reform in the medical and health system,making clear the working idea of "strengthening the foundation and building up a mechanism," and actively devoted itself to promoting the construction of the hierarchical diagnosis and treatment system.A series of measures such as medical association,family doctor system,reform of basic medical insurance policy were implemented so as to improve the service level and quality of primary medical and health service institutions and to guide patients to seek medical treatment at the grass-roots level,with further aims to change the situation of overcrowded hospitals and realize the effective allocation and rational use of medical resources.In terms of the reform of basic medical insurance policy,most areas in China tried to take advantage of price to attract residents to seek medical treatment at the grass-roots level by expanding the proportion of reimbursement at different levels of hospitals,however,the effect of this strategy was not that significant.The purpose of this paper is to research about how to further reform the basic medical related insurance policies,so as to give full play to the leverage role of medical insurance in classified diagnosis and treatment.Therefore,this paper is structured in the following five aspects by taking Nanjing City as an example:Firstly,this paper endeavors to do a related document searching of the hierarchical diagnosis and treatment and health care policy reform in China in order to grasp the overall development of the two.Secondly,this paper tries to analyze the necessity and logical reason for a combined reform between medical insurance and hierarchical diagnosis and treatment,and to study the current situation of the application of basic medical insurance in graded diagnosis and treatment in China.Thirdly,this paper uses the relevant data in the Nanjing Health Yearbook,and combines with empirical analysis,it studies the current situation of Nanjing classified diagnosis and treatment from the perspective of medical insurance.The paper finds that differential payment policy of Nanjing medical insurance was useful to lead patients to diagnose and treat in primary.health care institutions,but the effect was limited,so the basic medical insurance system should be further reformed.Fourthly,the paper introduces the international experiences of the impact on classification diagnosis and treatment of basic medical insurance system.The paper finds that in countries of refined classified diagnosis and treatment system,they values the coordinated reform of basic medical insurance system.The paper uses information above to give suggestions for Nanjing hierarchical diagnosis and treatment reform.First,the policies should be strengthened;second,payment of medical insurance should be enlarged,the reimbursement differences should be set according to medical institution classification,the way of payment should be reformed and we should combined type of payment according to the local reality.In addition,we should try to set medical insurance doctor system to encourage the negotiation mechanism between medical insurance and medical institution.It is hoped that the basic medical insurance system will be reformed to better its supporting role in the construction of graded diagnosis and treatment system.