ABSTRACT
Objective:This study aimed to evaluate the impacts of the separation between revenue and expendi-ture on the outcome of the payment policy"fix out of pocket". Methods: Using descriptive analysis, difference in difference(DID) model based on data from Wanning county where the new policy has been carried out,Ledong coun-ty where has not,including claim data and hospital utilization data from Nov 2010 to Oct 2014. We also supplemen-ted and interpreted the results of quantitative analysis combined with qualitative data from the interview recording ma-terial;Results:As for the two most common hospitalized diseases(hypertension and pneumonia),the number of in-patient visits in primary medical institutions didn't change respectively. From DID model, the policy only increased out of pocket(OOP) in Wanning by 11% and 28% and decreased average medical expense in Qionghai by 66% and 67% respectively. Conclusion:The separation between revenue and expenditure make the"fix out of pocket"pay-ment policy have better performance on the control of medical expense.
ABSTRACT
In recent years,Shanghai is exploring the implementation ot comprehensive budget management in community nealtn center,but facing some problems in process:the budget management model is still not unified,"separation between revenue and expenditure" policy is not really implemented,the financial subsidies is not combined with performance appraisal.Meanwhile within the center,the personnel funds are approved by public sector,the operation funds are not standardized,and project funds are relatively chaotic.It is recommended to carry out cost accounting of community health center,clarify expenditure,introduce standardized workload in community health center to promote budgeting scientifically,strengthen the information construction to make budget implementation assessment,and establish a performance appraisal linked to the government subsidy mechanism.