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Based on the urban residents' basic medical insurance system in Qingdao,with hospitals,community aging care institutions and families as the carriers,Qingdao city explored and implemented the long-term medical care insurance system(LTMCI),and established mechanisms for fundraising,payment,handling,service and supervision.The city also designed a scientific application and reimbursement process.Three service modes are designed and put into practice as follows:Long-term care in designated nursing homes or pension institutions; Medical care at designated hospitals; and home health care.These services are charged by quota-lump per bed per day,with the reimbursement ratio of 96％,90％ and 96％ respectively.A practice over a year proved the LTMCI as effectively alleviating disease burden of patients,and guiding long-term care to serve communities.This way a new type of medical care system comes into being,with medicine-care-recovery-endowment for disabled population.
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Objective To explore the effectiveness of the home-community-hospital network management (HCHNM) on the prevention and treatment of stroke.Methods From June to December 2011,HCHNM was implenented in Qingdao of Shandong Province to prevent and treat stroke patients.According to community residents healthcare records,A total of 80 stroke patients were randomly selected from Badahu and Fushanhou communities (study group) and another 80 patients from Zhongshan Road and Liaoning Road communities (control group).A household questionnaire survey was then conducted among these participants.Chi-square test and t test were used for data analysis.Results The overall effective rate of the study group was 86.25％ (69/80),which was significantly higher than that of the control group (67.5％) (x2=221.807,P＜0.05).The study group also showed largely improved quality of life (total score:t=4.593;physical fitness,family activities,movement,mood,self-care ability,social activities,upper limb function and work ability scores:t values were 7.775,2.244,5.329,3.832,5.463,2.979,5.924 and 3.555,respectively; all P＜0.05),although language,character,thinking and vision abilities had no statistically significant difference from the control group (t values were 0.561,1.466,0.831 and 1.000,respectively; all P＞0.05).The scores of daily activities and life satisfaction of the study group were higher than those of the control group,while per capita medical cost was much lower (t values were 12.998,20.760 and-29.777,respectively; all P＜0.05).Conclusions As an effective,safe and economy therapy model,HCHNM could improve rehabilitation,self-care ability,quality of life,and life satisfaction of community stroke patients.In addition,it greatly mitigates medical burden.
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A systematic summary of the concept and operational mechanism of the intensive disciplines management in a hospitals group,and that of the intensive disciplines management for hospitals groups,as well as a comparison of the differences found in department service capacity,service quality,discipline development and patient satisfaction before and after the intensive discipline management is in place.The practice proved that the departments practicing intensive management have witnessed significant rise in outpatient headcount,hospitalization headcount and surgical operation headcount.Their weight in the group is also higher.For example,their curative rate and rescue success rate of dubious and acute diseases higher than before (P＜ 0.05).The Group has 8 provincial key medicine-specialties,including 5 intensive management departments.It has 8 provincial key clinicaldisciplines,including 2 intensive management departments.The overall patient satisfaction for service of such departments is 92.1％,the satisfaction for convenience is 84.4％,that for service quality 90.0％,that for service attitude 92.5％,and that for medical service experience is 89.5％.All of which are significantly higher than that those on their admission to the hospital.The intensive management has enabled unified management of internal medicine and surgery of the same profession in the campus,integrated workforces of both internal medicine and surgery department along with those of medical technicians.In addition,it has enhanced departmental service capacity and quality,discipline competence,as well as outpatients' convenience,patients' satisfaction and medical experience.
RESUMO
Objective To study outcomes of the family doctor contact system and outpatient coordination system in Qingdao.Methods Random selection of 400 community residents and 576 outpatients for a questionnaire survey,using t tests and time series analysis.The purpose is to analyze the number of insured workers,community referrals,costs of hospitalization and the proportion of out-of-pocket payment,and impacts on community healthcare services.Results Number of insured works increased year by year,up to 1,739,931 in 2010.The proportion of community referred hospitalization was raised to 56.97％ in 2010 and increased 54.26％ compared to 2007.Hospitalization costs and the proportion of out-of-pocket payment were reduced.Conclusion The family doctor contact system and outpatient coordination system in Qingdao proved a success,as the practices were highly popular among the employees,and benefited community health centers as well,making it worthwhile to promote.