Construction of a Theoretical Framework for the Performance Assessment of Basic Medical Insurance Designated Medical Institutions Based on the Objectives of Medical Insurance Policy / 中国医院管理

It collected relative policy documents systematically and analyzed the development process and policy objective evolution of Chinese basic medical insurance system.Based on this,it determined the performance assessment objectives of the designated medical institutions of basic medical insurance and constructed the assessment framework guided by the goal realization.Then,from the perspective of contract management and performance management,it determined the assessment elements of contract enforcement assessment system of designated medical institutions and the logical relationship between the elements,and to construct a conceptual model,which provides a reference for guiding the research of the contract enforcement assessment of the designated medical institutions of basic medical insurance.

Practice and proposals for instant settlement management of the basic medical insurance / 中华医院管理杂志

The pilot work urban workers medical network settlement of Anhui province has launched in full scale,effectively facilitating the population seeking medical service elsewhere.In this regard,the medical settlement of a pilot hospital is cited as an example to introduce the networked medical settlement in remote places,summarizing problems encountered,and coming up with proposals accordingly.

Principals of selecting designated hospitals for inpatients of NRCMS with critical illness / 中华医院管理杂志

Objective To explore how to determine the designated hospitals for critical illness scientifically and reasonably.Methods Analyzing the choice of medical providers by inpatients with critical illness,by means of the database of NRCMS in 2009～2010 in one county,Guangxi province.And analyzing the current policies on the basis of general principals used in health policy analysis.Results The choices of medical providers made by inpatients with critical illness are influenced by various factors.Choice of such hospitals should only be dependent on scientific and reasonable determination of patients' reasonable medical needs,instead of on the medical competency of the hospitals only.Conclusion Maximal cost-effectiveness should prevail,be it the class-1 demand of complete healing which is highly dependent on medical technology,or class-2 demand requiring repeated hospitalizations and not highly dependent on medical technology.Reasonable designation of hospitals for critical illness should be based on reasonable medical needs of patients,instead of medical competency of hospitals only.