Study on the impact of county medical community reform on the medical insurance fund expenditure in M county, Lincang city of Yunnan province
10.3760/cma.j.cn111325-20201112-02108
- VernacularTitle:云南省临沧市M县医疗卫生共同体改革对医保基金支出的影响研究
- Author:
Juming LIU
1
;
Yiqing YANG
;
Heyun LU
;
Yao SHEN
;
Huaqin HU
;
Menglin FAN
;
Yangyang HONG
;
Zuxun LU
;
Yihua XU
Author Information
1. 华中科技大学同济医学院公共卫生学院 教育部环境与健康重点实验室，武汉 430030
- Keywords:
County medical community;
Medical insurance fund;
Expenditure indicators;
Interrupted time-series analysis
- From:
Chinese Journal of Hospital Administration
2021;37(2):98-103
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the impact of the reform of the county medical community on the expenditure of medical insurance funds, and to provide references for maintaining the stability of the medical insurance fund and deepening the reform of the medical community.Methods:Medical insurance data of urban and rural residents in M County, Yunnan province from 2016 to 2019 were collected, and a discontinuous time series model was used to analyze the impact of county medical community reform on medical insurance fund expenditures.Results:Since the reform, the number of patients discharged from county-level hospitals has shown a downward trend, averaging a decrease of 25.996 people per month; yet increases have emerged with the average hospitalization expenditure, the average hospitalization overall fund expenditure, and the average outpatient overall fund expenditure, averaging a monthly increase of 90.931 yuan, 50.014 yuan and 1.528 yuan respectively. The average hospitalization expenditure, the average hospitalization overall fund expenditure, and the average outpatient overall fund expenditure of the township hospitals all showed an upward trend, averaging a monthly increase of 31.191 yuan, 38.678 yuan and 0.085 yuan respectively. The flow of external medical insurance funds of the medical community has shown a continuous upward trend, averaging a monthly increase of hospitalization fund expenditures of 33.005 yuan, and a monthly increase of outpatient overall fund expenditures of 4.896 yuan overall.Conclusions:The M County medical community should further strengthen the top-level design, explore the reform of medical insurance payment methods, improve the regional information platform, standardize the referral system, and strengthen supervision to deepen the construction of the medical community to ensure the sustainable operation of medical insurance funds.
