Analysis on the implementation effect of single disease payment policy for day surgery based on difference-in-differences model / 中华医院管理杂志

Objective:To analyze the implementation effect of single disease payment policy for day surgery (hereinafter referred to as the policy), for references for the reform of medical insurance payment.Methods:By collecting the information of inpatients from 2017 to 2019 in a tertiary hospital, the research group took patients with colorectal benign tumor and nodular goitre as the policy implementation group and the control group respectively. 2017-2018 was the pre implementation stage of the policy, and 2019 was the post implementation stage of the policy. The difference-in-differences (DID) model was used to analyze the changes in indicators such as length of stay and hospitalization expenses after policy implementation, under whether the policy is implemented or not, as well as before or after policy implementation.Results:A total of 2 419 patients were included, including 927 patients with nodular goiter in the control group and 1 492 patients with colorectal benign tumors in the policy implementation group (688 patients before the policy implementation and 804 patients after the policy implementation). The results of DID showed that the hospital days for patients with colorectal benign tumor decreased by 56.53%, the hospitalization expenses decreased by 26.51%, the out-of-pocket expenses decreased by 26.66%, the treatment expenses increased by 11.96%, the drug expenses decreased by 50.29% and the consumables expenses decreased by 20.23% after the implementation of the policy.Conclusions:The implementation of the policy could reduce length of stay, hospitalization expenses and out-of-pocket expenses, optimize the structure of hospitalization expenses, improve the efficiency of hospital diagnosis and treatment, and help the hospital realize its transformation from a size expansion to a quality and benefit expansion.

Status, problems and improvement measures of health insurance reimbursement of national negotiated drugs used in outpatients / 中国药科大学学报

@#The access negotiations of National Reimbursement Drug List (NRDL) in China from 2017 to 2019 effectively improved the availability and affordability of high-value innovative drugs. However,the actual outpatient reimbursement of most negotiated drugs is lower,which affects the patients" health insurance funds. In this paper,97 negotiated drugs in 337 overall planning cities were selected as samples to analyze the outpatient reimbursement for negotiated drugs. The results showed that the reimbursement level of 40 negotiated drugs was less than 50% in over 70% cities,which can be mainly interpreted as absence or imperfection of outpatient reimbursement policies for special diseases. Finally,this paper puts forward suggestions and protocols for improving the outpatient medical insurance through realizing outpatient overall planning,improving outpatient reimbursement policies for special diseases,and exploring innovative payment,ensuring the achievement of the access to NRDL.

Further Discussion on the Problems and Countermeasures of Single Disease Payment Reform / 中国卫生经济

Through the investigation of the single disease policy and the local actual situation in many regions of the country, it analyzed the practical problems faced by Chinese medical institutions in the implementation of single disease payment policy. The necessity and urgency of the national unified single disease payment policy were put forward, and the system of standard quota payment for single disease standard was preferred, supporting patients to pay extra fees for differential medical services, standardize the accounting policy of single disease payment.

Analysis on the influence of single-disease payment method on medical service quality: bladder cancer as an example / 中华医院管理杂志

Objective To analyze the impact of medical service quality after single-disease payment method was in place at a number of tertiary hospitals in Tianjin .Methods Retrospective analysis and satisfaction questionnaire were used to choose 1035 cases of bladder cancer from January 2015 to May 2017 , consisting of 522 cases settled in conventional medical insurance payment prior to the reform , and 513 cases settled in the single-disease payment.300 patients were selected from each type plus 128 doctors, for satisfaction questionnaire survey .Results The single-disease payment method , since in place , had cut back the average days of stay by 1.27 days, per-capita inpatient medical expenses by 1237 yuan, average out-of-pocket payment by 3890 yuan, and the non-payment amount by 11 yuan.Both patients and doctors were more satisfied than before to a different extent , with the difference statistically significant (P<0.05). Conclusions Single-disease payment method can control the cost obviously , thus conducive to the quality of medical services .

Discussions on case-based payment practice in China and the overseas DRGs experiences / 中华医院管理杂志

Discussed in the paper are case-based payment practice in China,and outcomes of this practice for the past ten years.The authors pointed out that compared with DRGs,such a practice is exposed to such risks as low coverage of diseases,incompatible policies,defective pricing method,and lack of comprehensive evaluation.It indicates that China is on the initial stage of case-based payment reform which should be promoted with reference to international experiences.

Composition and Influential Factors of Hospitalization Expenses in Inguinal Hernia Inpatients Under the Single-disease Payment Standard of Medical Insurance / 药物流行病学杂志

Objective:To analyze the hospitalization expenses in inguinal hernia inpatients under the single-disease payment standard of medical insurance.Method:A retrospective study was performed to analyze the data of inguinal hernia patients who received inguinal herniorrhaphy in 2006.According to the regulations worked out by the Beijing Medical Insurance Affairs Administration,32 cases were selected and their medical costs were characterized.Result:The average hospitalization expense in inguinal hernia patients was 5722.37?2967.66 yuan,including surgery cost(45.6%) and drug cost(26.7%).The surgery cost level depended on the selection of various hernia prosthetic mesh and the drug cost depended on the selection of various anti-infective drugs.The hospitaliztion expenditures were lower in 18 cases than the payment permission in the medical insurance standard but higher in the other 14 cases.The sex composition,surgery cost, drug cost and laboratory cost showed a significant difference between the two groups(P

Research on Issues of Fee Charging in Informatized Hospital / 医疗卫生装备

Objective To discuss the issues encountered in fee charging,mainly the automatic recognition of charging agent.Methods Based on No.1 Military Medical Project,the present status of fee charging in the hospital was analyzed.The single disease payment system and charging system adapting to all kinds of medical insurance policies were designed,whose payment decomposition flow was introduced.Results The payment decomposition flow,compatible with all medical payment regulations in China,was applied in the outpatient department charging system of General Hospital of PLA.Conclusion The payment decomposition flow,is gifted with universal validity for complicated charging conditions in China.