ABSTRACT
Objective:To explore the impact of the clinic-pharmacy separation reform in Beijing on the outpatients with medical insurance.Methods:A segmented regression model of interrupted time series(ITS)data was used, to analyze the changes from April 2017 to May 2019 in outpatient visits, average cost per visit, out-of-pocket burden, with a tertiary hospital in Beijing as an example before and after the reform.Results:Segmental regression analysis showed that since the reform, the out-of-pocket burden of outpatients fell by 5.2% in the first month. After the reform, the medicine expenses decreased 0.50 yuan monthly instead of increasing 0.24 yuan before, and the surgery expenses, examination and laboratory fees, and materials expenses have increased from an average monthly increase of 0.14 yuan, 0.64 yuan and 0.36 yuan to 0.15 yuan, 0.70 yuan and 0.17 yuan respectively. Meanwhile, the growth rate of outpatient services slowed down, with an increase number dropping from 855 visits/month to 523 visits/month.Conclusions:The reform had reduced the out-of-pocket expenses of outpatients.
ABSTRACT
The medical management department of individual hospitals varies with their organizational structure and operational mechanism, instead of following a general pattern. Inspired by the"super-ministry" system of government,the hospital has integrated successively the Medical Affairs Office, Patient Safety Office,Medical Quality Control Office,Hospital-acquired Infection Control Office and Medical insurance office. Through integration and innovation of duties, regulations, culture, decision-making progress,coordination and talent training mechanism, the " Five-in-One" super-ministry model of medical management came into being,achieving collaborative and efficient medical management as a result.
ABSTRACT
The construction of DRGs management information system proves conducive to hospital medical quality management .In order to better understand the status of the hospital′s DRGs, further improve the quality of medical care , and embrace the DRGs reform in medical insurance , the hospital built the DRGs management information system in 2015 , and integrated it with the electronic medical record management system, and the medical record management system .The system consists of such modules as inpatient medical service evaluation , disease surveillance , case analysis , and real-time dynamic monitoring , applied to homepage evaluation and performance management at both hospital and department levels .Such a system can provide practical data for decision support of clinicians , and enable decision makers , thus improving fine management of medical care in the full course .