Proportion of payment-at-one's-own-expense of the public medical service in military hospitals and cost control
10.3969/j.issn.1009-0754.2017.02.024
- VernacularTitle:军队医院医保自费比例构成与控制分析
- Author:
Dan LI
1
;
Leiming SHEN
;
Jia LIU
Author Information
1. 海军总医院医疗保险办公室
- Keywords:
Medical insurance;
Proportion of pay-at-one's-own-expense Medical cost;
Cost control
- From:
Journal of Navy Medicine
2017;38(2):167-169
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the composition and proportion of the payment-at-one's-own-expense of the public medical service for those eligible people who could have medical care in military hospitals.Since the introduction of proportion of the paymentat-one's-own-expense into the performance indexes,analyses were made on the cost control of the proportion of payment-at-one's-ownexpense from 2011 to 2015.At the same time,when it was compared with the hospitals of same level,total medical costs could be controlled through the control of the proportion of medical service with payment-at-one's-own-expense,so that military hospitals could better serve the patients who were eligible to public medical service.Methods With the help of the Health Information System (HIS) of a certain military hospital in Beijing and the Information Query System of the Medical Insurance Business Terminal in Beijing,the proportion of the payment-at-one's-own-expense of the public medical service in 2015 was analyzed.Then,the growing trend of the proportion of the payment-at-one's-own-expense of the medical service system from 2011 to 2015 was statistically analyzed,and this proportion was horizontally analyzed with that of the identical hospitals of thc same level.Results The main reasons for higher proportion were drugs,laboratory tests and treatment,and medical materials.With the implementation of "total sum payment system" from 2011,in Beijing,and with the introduction of the proportion of the payment-at-one's-own-expense of the medical service system into the performance indexes from 2011 to 2015,this proportion was considerably decreased from 2011 to 2012.However,from 2012 to 2015,this proportion was gradually increased year by year,with the growth rate being lower than that of the average level of tertiary comprehensive hospitals.Conclusion The problem on the control of the proportion of the payment-at-one's-own-expense of the public medical service should be tackled from the source,Strict control on the rising costs of drugs,laboratory tests and medical materials is the focus of all the urgent issues.Repeated laboratory tests and treatment should be avoided.At the same time,attention should be paid to the rising costs of medical materials.Therefore,comprehensive measures should be adopted to control the proportion of the payment-at-one's-own-expense and the payment of total medical costs as well,so that economic load on patients could be relieved.
