Design consideration and implementation outcomes of the long-term medical care insurance / 中华医院管理杂志

ABSTRACT

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 followsLong-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.