Through collecting the economic operation information of the society-run blood purification institutionrs,the cost is divided into fixed cost,variable cost and mixed cost according to the relationship between the cost and the number of dialysis.It formulated the standard cost model of blood purification institutions,according to the county and city classification,the basic situation of the size and capacity of the organization were assumed.It mainly included standard labor costs,standard drug costs,standard health materials fees and standard professional equipment depreciation and other information,which was benefitial for industry decision-making and internal fine management.

It aimed to analyze the price disclosure system of genetic drugs in Australia.Based on the analysis of background and historical evolution,it tracked each step of price disclosure on the basis of descriptive statistics and analvsis so as to provide reterences for constructing the price disclosure system of genetic drugs led by market factor under the effective conduct of future medical reform policy in China.

To deal with the current large workload and difficulty of reconciliation for medical insurance expenses in public hospitals,it proposed a institutionalized and normalized reconciliation management process.Tianjin was selected as the object of research.Based on hospital and medical insurance institutions,it analyzed the existing problems and reasons of medical insurance on reconciliation.It proposed a medical insurance debt accounting based,medical settlement information establishment supported,medical insurance reconciliation process centered medical insurance reconciliation management work system to solve the problem of medical insurance reconciliation and promote the safety and integrity of the obligatory right for medical insurance.

Based on the analysis of the role of financial management promoting the transition in public hospitals development model and management accounting talents demand for public hospitals development model transition,it put forward relevant policy advices to speed up public hospitals accounting personnel training and improve business ability,including relying on the national accounting leading and backup talent training project,meeting the demand of high-end financial talents in hospitals;adapting to internal control and hospitals development,increasing investments for financial personnel training,training business backbone and management experts and raising the overall level of economic management.

Objective:To figure out the characteristics of annual medical expenditure for rural residents and its distribution among different population.Methods:The individual annual medical service utilization information was summarized after dealing with the database of the 2014 new rural cooperative medical system by Excel.It prescribed the clustering of medical expenditure by Lorenz curve and Gini index.Descriptive statistics and x2 test were used to compare the characteristics and distribution of the annual medical expenditure among rural residents.The Chi-square test was conducted to compare the differences of the population distribution.Results:The costliest 5％ patients accounted for approximately 68％ of total health care expenditure.The annual total expenditure was 16628 yuan per capita among high-cost population,while low-cost population were 108 yuan.The Gini index of medical expenditure for rural residents was 0.81.Among female and population over 45 years old,the proportion of high-cost population was higher than 5％.People living near provincial road,in flatlands or areas where the ability of township hospital was limited were nore likely to expense higher medical costs,known as 6.40％,5.50％ and 5.80％ separately.Conclusion:Clustering of medical expenditure for rural residents was remarkable,while the expenditure among high-cost,medium-cost and low-cost population were quite different.The elderly,female and primary population living in areas where the ability of township hospitals were limited were more likely to generate high medical costs.

The government purchasing of community health service was an important way to change the mode of health service supply,which was also an important way to improve the primary health service supply system.On the basis of government purchasing of community health service development in China,it analyzed the current situation and insufficient coverage of Shenzhen municipal government purchasing community health services,proposed the improvement strategies for improving government guarantee and management capacity,standardizing government purchasing process and enhancing the management of relationship among the main bodies so as to solve the problems of insufficient government guarantee level,nonstandard purchasing process and insufficient cooperative management concept.

Objective:To compare the changing trends and differences of bed numbers,doctor numbers and medical service utilization in the US.and China so as to provide polity implication for the health care reform in China from the supply side.Methods:The data of beds,doctors,hospitalization and outpatient service utilization from the website of OECD and CDC of the United States as well as Chinese Statistical Yearbook of Health and Family Planning were used to describe the trends.Results:The beds per 1000 people in China had exceeded that of the US,while the doctors per 1 000 people in China was less than the US.Both the two countries had yearly increasing trend of outpatient visits.However,the hospitalization was decreasing in the US,while the growth rate of hospitalization was even higher than the outpatient visits in China.Conclusion:The decrease of bed amount and the increase of outpatient amount were the main changing trend of medical resources and service utilization in the US.The imbalanced structure of medical resource supply in China resulted the overuse of hospitalization services.In the supply side reform of medical reform in China,it suggested to promote the cooperation of medical insurance,drug and health care,adjusted the reform thought from resource amount into the promotion of service quality,changed the health management system from disease centered into health centered.

In the health service field,health resources and health service supple capacity were related with the resource and capacity in economics.Health resources,health service supple capacity and their relationships were important factors for the cooperation and benign interaction of hierarchical medical institutions.However,inversion of health resources and health dislocation of service supply capacity exacerbated the agglomeration degree of patients in the tertiary medical institutions under the impact of residents' freely searching for medical service concept.Vicious interaction and mutual competition among hierarchical medical institutions had become an important obstacle for the implementation of hierarchical medical services.Therefore,its mechanism needed to be clarified while the corresponding policy recommendations should be proposed.

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

Objective:To study the influence of transfer payment on the equalization of medical and health services.Methods:Based on panel data of China's 23 provinces from 2000 to 2014.the medical and health services equalization indexes were measured and developed as the explained index.The explanatory variables such as transfer payment,per capita GDP and health care input were involved.The threshold value of time and transfer payment were applied to developed to conduct the panel threshold regression.Results:Transfer payment significantly promoted the equal distrihntion of health service resources,but the elastic declined if transfered more than 33 billion yuan as the threshold.Meanwhile,there was a threshold effect that the elastic of transfer payment to the equalization of China's medical and health service declined after NCMC in 2003.Conclusion:To further increase transfer payment,it needed to enlarge the new farmers and scope,optimize the equal distribution of health service resources.