Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

Objective:To estimate the scale,expenditure and financing structure of potentially preventable hospitalization(PPH)for diabetes in Shenzhen,and provide data support for improving the utilization efficiency of medical and health resources.Methods:The System of Health Account 2011 was used to calculate the status of PPH for diabetes in Shenzhen and its cost scale and structure.Results:In 2019-2022,there will be a total of 441 426 avoidable hospital admissions for diabetes,hypertension,angina,influenza and pneumonia and dehydration and gastroenteritis,which cumulatively account for approximately 70.00%of admissions.The cost of hospitalization could be avoided by 525 028.06 million yuan,accounting for 6.18%of the total costs.The out-of-pocket costs were 1 762.724 4 million yuan,accounting for 33.57%of the total avoidable hospitalization costs.The out-of-pocket payment of angina pectoris,gangrene and rheumatic heart disease were higher and the proportion of out-of-pocket costs was larger.Conclusion:The large scale of hospital can be avoided in Shenzhen,and the waste of medical resources caused by unreasonable hospitalization is serious.The level of primary health care should be improved,the behavior of doctors should be regulated,the role of intervention in diseases of key populations should be increased,and the system of reimbursement of health insurance should be optimized.

The United States is the country with the most pilot practices in value-based healthcare payment reform, and value-based purchasing (VBP) is one of its pilot projects. The authors introduced the basic situation and implementation effects of the pilot projects of VBP payment reform in the United States from the hospital and physician levels respectively, and analyzed the causes for their unsatisfactory implementation effects. Then, the authors proposed its enlightenments for China from such aspects as the construction of value-based medical payment index system, implementation of value-based medical payment reform, and management costs, to provide reference for the construction of high-quality value-based medical service system in China.

The pilot project for alternative payment models was originated from the implementation of the 2010 Affordable Care Act in the United States, which aimed to establish a new payment mode to replace the traditional payment based on service fees, thereby achieving the goals of ensuring healthcare quality, reducing healthcare costs, and improving healthcare equity. The pilot projects of alternative payment models included two types: accountable care organizations and bundled payments for care improvement. The authors introduced their profile and implementation effects, analyzed the causes of the current implementation effects, and then proposed enlightenments for the value-based medical payment reform in China, with the aim of providing reference for the construction of a high-quality value based medical service system in China.