Discussion on Medical Costs Control in China from the Perspective of the Relationship among Doctors, Hospitals and Health Insurance Institutions in the United States
10.6039/j.issn.1001-0408.2016.16.04
- VernacularTitle:从美国医师、医院、医保机构的制约关系探讨我国医药费用控制
- Author:
Maomao ZONG
;
Xiaomin YOU
;
Rui ZHAO
;
Li YUAN
;
Yue YANG
- Publication Type:Journal Article
- Keywords:
Doctor;
Hospital;
Health insurance institution;
Restrictive relationship;
Medical cost;
United States
- From:
China Pharmacy
2016;27(16):2172-2176
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are hierarchical medical system and two-way referral system;for-profit hospitals and non-profit hospitals are mutually complementary;different natures of health insur-ance system,different payment methods and strict“commercial bribe”monitoring system are carried out;doctors,hospitals and health insurance restrict each other. Not only there are many advantages in theory,but also in practice the growth rate of medical cost and the percentage of drug expenditure are superior to our country. Finally it controls the rapid growth of medical cost to a cer-tain extent. Combined with our national conditions,learning from the United States experience,restrictive relationship among doc-tors,hospitals and health insurance institutions is established to control the increase of medical cost in China through reducing infor-mation asymmetry and standardizing payment audit;establishing a scientific pattern of mixed payment;strengthening the indirect impact of the health insurance institutions on doctors and hospitals,etc.
