Résumé
Objective To analyze implementation outcomes and obstacles of “treatment before payment” reform seen by medical institutions' managers,along with an optimal strategy proposed.Methods Quantitative survey and qualitative interviews were called into play,and the data so acquired are subject to evaluation of the radar chart and fishbone diagram analysis to learn the implementation outcomes and obstacles.Results The reform proves workable at hospitals of county and lower levels,achieving win-win for the people,hospitals and government.Obstacles found include poor allocation of designated funds for risk coverage,insufficient circulating funds in advance,poor risk aversion mechanism,and poor preparation for tertiary hospitals.Conclusion It is recommended to promote awareness of the reform,enhance inter-department cooperation,improve hospital information systems,clarify the screening standards of “purposely evasion offenders”,standardize the issuance and use of the NRCMS certificates,and better build the credit system of the society.
Résumé
Objective To evaluate outcomes of the reform and recommend on risk avoidance.Methods The retrospective descriptive analysis was called into play to compare the surveillance data of the medical institutions before and after the reform.Results Significant changes have been identified in such key elements of the institutions as medical service,quality of care,efficiency,and costs.Improvements include effective release of the medical needs of patients,much higher efficiency of medical staff,shorter days of stay,and drug proportion,in addition to reasonable control of the total inpatient expenses,and further cutback of the patient's out-of-pocket burden.Conclusion With other factors excluded,the reform can benefit the patients and help medical institutions development,if risks are avoided and measures improved.