Study on the doctor-patient interest demands satisfaction of the payment system reform in China's new rural cooperative medical care scheme / 中华医院管理杂志

Objective To study doctor-patient interest demands satisfaction and its influencing factors of the payment system reform of the new rural cooperative medical care scheme to provide reference for the reform. Methods Cross-sectional survey was conducted from September 2016 to February 2017. Multi-stage stratified random sampling was used in six counties of three provinces in the eastern, middle and western regions of China, and mathematical statistics was applied to analyze the data. Results The doctor-patient overall interest demands satisfaction was high, but the satisfaction was lower both with the income and ability improvement of medical staff and with the benefits of farmers. The influencing factors of the satisfaction of managers in medical institutions included the type of payment, educational level and work unit (P＜0.05). The influencing factors of medical staff's satisfaction included the type of payment, work unit, and working years among others(P＜0.05). The influencing factors of farmers'satisfaction included the type of payment and the average annual income, etc(P＜0.05). Conclusions The core interest demands of both doctors and patients should be valued to enhance their satisfaction. Diseases related groups should be promoted and applied scientifically, and appropriately integrated with other methods of payment. Both doctors and patients'understanding of the payment reform should be improved by propaganda and training, to get their support and cooperation.

Study on the participating farmers'interest demands for the payment system reform in China's new rural cooperative medical care scheme / 中华医院管理杂志

Objective To study the participating farmers'interest demands for NRCMs in order to provide basis for the payment system reform based on the demand side perspective. Methods A cross-sectional study was conducted from September 2016 to February 2017. Multi-stage stratified random sampling was conducted in six counties of three provinces in the eastern, middle and western regions of China. Mathematical statistics analysis was conducted to clarify the interest demands and influencing factors of the participating farmers. Results The interests claims of the 1 452 participating farmers were to improve service quality, to reduce the economic burden of disease, and to standardize the management. The medians found were 4.00, 4.00 and 3.63 respectively. Relative to the flat rate, the DRGs raised higher requirements for standardized medical behaviors offered by the medical workers. Furthermore, it called for effective medical quality supervision, rigorous control of medical costs and highly scientific and standardized management. The differences were statistically significant ( P ＜0.05 ). Conclusions The diversity of participating farmers'interest demands deserves due attention, the payment methods combination should fit local needs, the interests demands expression channel of the participants should be expanded, and the demand side deserves a due role in supervision of the funds.

Analysis of the impact of the disease-based hierarchical medical system on the inpatients flow covered by the new rural cooperative medical system / 中华医院管理杂志

Objective To understand the influence of the disease-based hierarchical medical system on inpatients flow covered by the new rural cooperative medical system ( NRCMS) , and that on the funding diversion and medical costs so incurred. Methods One county was selected from the eastern, central and western regions of China respectively, where the disease-based hierarchical medical system has been in place. Policy documents of the three counties were reviewed to analyze such changes as NRCMS inpatients flow, inpatients subsidy diversion, NRCMS fund surplus rate of the current year and medical costs per hospitalization before and after the system was in place. Results A comparison with 2014 found a 1. 26%drop of the out-of-county inpatients of county W of the western region, a 2. 00% increase of township hospitals inpatients of county D in the middle region, and the same ratio of out-of-county and in-county inpatients in county F of the eastern region in 2015. Compared with 2014, the fund surplus rate of county W increased 10. 46%, and the inpatient subsidy ratio of county D decreased 2. 51% for those in out-of-county medical institutions in 2015. Thanks for the quota payment of specific diseases under global budget in county W, the inpatient medical costs per hospitalization dropped at both county and township medical institutions. Conclusions The disease-based hierarchical medical system could optimize the NRCMS inpatients distribution among various medical institutions, conducive for establishment and operation of such a system.

A Probe into the Practice of Self-help Service of "Prescription Set" in Cooperative Medical Care Clinic Service in Countryside / 中国药房

OBJECTIVE:To probe into the effects of carrying out"Prescription Set"self-help service in cooperative medical care clinic service in countryside in lessening the economical burden of peasants patients and enabling more people benefited from the basic health care.METHODS:Targeting at the common diseases in clinic service of the health center,for each of which at least3kinds of treatment plans prescription in different prices were worked out,to make the peasants patients choose the prescription freely.RESULTS&CONCLUSION:The outpatient number has increased significantly while medical expenses on prescriptions of outpatients decreased significantly in the primary level hospitals and community clinics through the practice of"Prescription Set"self-help service.

Probe into and reflection on cooperative medical care for laborers in Shenzhen / 中华医院管理杂志

In order to set up a medical security system suitable for laborers and solve for them the problem of inadequate and expensive medical services,the city of Shenzhen started on March 1,2005(apilot) cooperative medical care for laborers in the four neighborhoods of Buji,Longgang,Longhua and Shajing on the basis of an earlier model.The new model,which stipulated that each person paying 12 yuan each month,with the employer paying 8 yuan and the individual laborer paying 4 yuan,was entitled to both outpatient and inpatient medical services,was popular with both businesses and laborers.At present the number of people participating in the new model of cooperative medical care for laborers exceeded 1 million,the number of designated medical institutions was gradually increasing,and medical expenses were put under control.

Review of and reflection on the experiment of cooperative medical car e in distressed rural areas / 中华医院管理杂志

With the support of international organizations like the United Nations Children's Fund, the Health Economy Network conducted a five－year experimental study of various forms of cooperative medical care in 10 counties involving 8 provinces of the country. The paper reports the results of a survey of 8 141 persons from 2 076 households. The rate of insurance coverage of individuals reached 73.7%. Among the peasant households that participated in cooperative medical care, 54.6% received compensations, 38.9% thought that their economic burdens had been lightened, 43.3% thought that it was more convenient now to seek medical service, and 41.5% thought that service quality had been improved as a result of cooperative medical care. Comparison with the control group indicates that adoption of cooperative medical care can provide community residents with medical and health security, lighten their economic burdens and enhance the utilization of health services.

Effect of the new cooperative medical care on the use of outpatient services by the rural residents in Dongying / 中华医院管理杂志

Objective To analyze the effect of the new cooperative medical care on the use of outpatient services by rural residents so as to provide scientific basis for its improvement. Methods Using the stratified cluster sampling method, house-to-house surveys on the residents of Dongying via interviews were conducted both before and after the implementation of the new cooperative medical care. Results Although the two-week rate of seeking medical services by the rural residents after the implementation of the new cooperative medical care did not increase, changes did take place in the flow direction of the patients and the rate of seeking medical services at the end of two weeks took a downward turn. Fairness in the use of health services by the residents was enhanced. Conclusion The new cooperative medical care strongly guarantees rural patients' access to medical care.

Study on the Compensatory Schemes of New-style Rural Cooperative Medical Care System of Longling County,Yunnan Province / 昆明医科大学学报

Objective To probe into the compensatory schemes of new-style rural cooperative medical care system(abbr.NCMS)of Longling county to guide the practice and serve as a referential mode for operating comprehensively NCMS in Yunnan.Methods Epidemiological Field Research method.Results The NCMS compensatory schemes of Longling county was "family account adding compensating the cost of hospitalization in subsectionmode".In 2004,Longling county adjusted the compensating measure of hospitalization on the basis of preserving the scheme of family account.There was statistical significant difference(P