Payment Model Study For Clinical Surgery In Public Hospitals With Service Orientation

Study backgroundFor long term, under the background of self profit-making, public hospitals use the accounting model of payment with 2 levels, hospital and department, for sake of survival and development. This kind of calculation model played key role for hospital development and brought more economic benefits. However, it also caused many problems for public hospitals such as benefits focus, over treatment and higher medical cost etc., which makes the curing burden of patient heavier, negatively impacted brand building and sustainability accordingly. So it is a very important topic to study how to reform the encouraging mechanism and compensation and benefit allocation method with profit making driven based on the balance of income and cost. In recent years, measures and regulations of national medical mechanism reform gave us the directions to build a modern compensation and benefit calculation model based on work load and service quality closely related with personal performance.Purpose of studyTransfer current payment accounting model with 2 levels to service based mode. re-build the accounting model and allocation method by linking with personal performance reflecting fairness and values of different service items with service basedObjective and contents of study1、Analysis and summarize current problems existing in the area of payment accounting, conducted logical inference, highlighted the key points to solve problems2、Clearly defined reasonable factors in payment allocation model by consulting and interviewing experts, based on which the payment allocation system was built up linking with performance in hospitals3、Focus on the study of accounting model by transferring working load to payment, pointed out the inadequacies of time based method, defined one kind of reasonable accounting model for payment:model based on quantity of valuable points4、Conducted the comparison of 2 accounting models by simulation in one clinical surgery department of specialized hospitals, introduced and verified the logic and effect on this new model Study method1、Analysis the cream of literature-Collected both national and international literature from 2004 to 2013, relative documents and regulations, analysis the payment evaluation method of key factors on payment allocation, accounting model and working load calculation etc.2、Consulting experts-Collected inputs from 15 experts who have rich experience in the area of hospital management and study on payment allocation, studied the logic and method of payment allocation and work load calculation, established the key factors of filtering performance indicator and work loading values3、Intention investigation-Forming the main frame and points of payment allocation model as a proving topic, selected 40 experts to further discuss4、Use questionnaire-Taking the random sample, investigated and studied the time allocation of doctors on medical work in one of the clinical surgery department in one specialized hospital, established the transfer standard of different work loading and adapted level of payment model with time based5、Simulation model-Simulated and verified the payment accounting model based on service taking the example of one specialized clinical surgery departmentAchievement of study1、Under the base of pointing out key issues of current payment accounting model, clearly defined reasonable factors of payment allocation method, service orientation based on work load and service quality. Built the hospital payment system made up of 5 parts including work loading bonus, medical quality bonus, service bonus, cost control bonus and educational research bonus2、Aiming at method of transferring work load to payment calculation, this article defined one kind of reasonable accounting method:payment based on valuable points. This article introduced its logic and work steps, illustrated the puzzles on how to do work load conversion, how to build link between work load and payment, and how to set coefficient of difficulty. Also this article pointed out that the method of payment based on valuable points cut off the incoming channels of medical workers, solved measuring problem of working values, encouraged doing the difficult surgery items with high technology and high risk, meanwhile the payment accounting method based on valuable points is easy and economic to implement3、Taking A specialized hospital as an example, this article introduced the payment allocation method based on service in clinical surgery department, and simulated the new payment calculation platform with excel by changing key measuring indicators, provided guidance to hospital leadership for decision making...