Study On Software R&D In Program Development Of New Rural Cooperative Medical System

â– Background and ObjectivesThroughout the history, the rural cooperative medical care system experienced a road full of ups and downs. There were still many challenges in the development of cooperative medical care system, in which, the requirement of enhancing the management level had got our attentions. In particular, the implementation of the compensation program was not only related to the benefits of farmers, but also to the reasonable use of funds. Hence, how to improve the new rural cooperative's overall compensation package, especially the reimbursement of large medical expenses, was the new rural cooperative system's infrastructure and core.Since new rural cooperative medical system (NRCMS) was mainly based on comprehensive arrangement for serious disease, and the reimbursement for hospitalization had always been the main expenditure of NRCMS, how to adjust the compensation package for the hospitalization had become the most important part of the policy. At the beginning, it was clearly stated that NRCMS would mainly be used for the reimbursement of large medical expenses or hospitalization expenses. It was still required in the polices issued after 2004 that adhering to the principle of comprehensive arrangement for serious disease, the local government should determine the subsidy way of NRCMS, and actively explore the subsidy way featuring comprehensive arrangement for large medical expenses taking into account the small fee.The absence of the main techniques risked the NRCMS healthy development. The extending of the main techniques had been obstructed by the gap between the complications of the program determination of NRCMS and limitations of the professional operator in basic-level. The study was aiming at helping local government solve funding problems of NRCMS, with grasping the medical risks, quantifying the degree of poverty caused by medical fees and monitoring the situation of funding, and finally developing a set of systematic, user-friendly, operation-simplicity software as policy decision-making reference tool.â– Materials and MethodOn this study, we selected the VBA (Visual Basic for Application) language of Microsoft Excel as program environment. Methods employed in this study included literature epagoge, household survey, focus group discussion, second-hand data collection, logic deduction and mathematic model analysis and simulation demonstration, etc. Besides these methods, several techniques of Knowledge Discovery in Databases (KDD) would be applied in this study.This study used reimbursement data from medical care management database of a county in the year 2006 and 2007, mainly relying on the reimbursement database of hospitalization, which provided a detailed record of each patients, including age, sex, medical expenses, reimbursement and so on.â– Main ResultsAccording to the requirements of the software design, the study made a summarization of the early research results. The software made the major objects of NRCMS into the two function modules, namely, evaluation module and monitoring module, which would be used for results evaluation and process control of programs. And the evaluation module was composed of 2 sub-modules, which were aiming at calculating the economic risk of medical care and the degree of poverty caused by medical fee.The study emphasized particularly on the established techniques of eliminating impoverishment due to medical expenses. Software implement included the main functions of these techniques in a set of program. The functions included:"work out recommendatory programs", "program adjustment", and "pre-evaluation". Herein, software calculated the reimbursement of every hospitalize behavior under the certain reimburse program. All reimbursements were accumulated to be the collecting amount, and after comparing some indexes, we would get a complete evaluation of the program. In this study, the software had greatly reduced the computing time, adequately reflecting the simplicity of software.As the innovation of the study, the function of monitoring the risk of program took the historical data as an indicator to reflect the current monthly expenditure of the funds. Through certain charts, the software would make a description of the monthly expenditures of the fund.â– Major exploration and innovation1. Realization of connection with "Standards"With the construction of new rural cooperative information systems, the pilot areas would gradually establish and improve the new rural cooperative data management system. Since currently there had not yet been any study on the system of "standards", it was the major innovation of this software to realize the connection with the current information system of NRCMS.2. Provide the function of rick warningThe study put forward the modular design for risk warning on fund expenditure. It focused on the hospitalization reimbursement and monitoring the programs, thus reflecting the actual situation of fund expenditure and providing the basis for the formation of the best program.