Analysis Of The Key Stakeholders Of The Regional Vertical Medical Consortium And Its System Simulation

In the new medical reform period,Medical Consortium was one of the measures to alleviate the problem of difficulty and high cost of getting medical service.Medical Consortium is a new type of organization with multiple stakeholders.It is of great importance to explore the relationship between the key stakeholders and to rationalize the relationship between the Medical Consortium and the key stakeholders.This study draws on the new health care reform and the national health servic e system planning outline(2015-2020)and other documents.Based on the class ification of Medical Consortium,this paper studies the key stakeholders of the regi onal vertical Medical Consortium and give systematical analysis to it.Combined wi th the results of the study,we will put forward relevant recommendations.Based on literature meta-analysis,Medical Consortium can be divided into thr ee development periods,namely budding stage involving the generation of medical treatment combination from 1980 to 1989,extended period about the formation of medical treatment combination from 1990 to 2009 as well as new reform period co ncerning the rapid development of medical treatment combination from 2010 to 2016.Classification methods have been developed continuously,but it is lack of syste matisms still.The division of Medical Consortium is divided into three dimension s: the joint action,the regional span and the degree of cooperation.The medical t reatment association can be divided into 8 types according to the three dimensions,and the characteristics of the 8 types of Medical Treatment Association and the fu nctional objectives are not the same.We identify the key stakeholders of Medical Consortium based on the study of Mitchell.According to his research,power,legitimacy and urgency are the impor tant reference for the classification of stakeholders.According to the score,we see n Health and Family Planning Commission,Medical insurance Department and terti ary hospital as key stakeholders.The Patient,two-level hospital,Community healt h service centers,the public and other Medical Consortium could be defined as co mmon stakeholder.Medical Association,medical equipment suppliers,judicial depa rtments,universities and research institutions,family members of patients could be defined as marginal stakeholder.The system dynamics method is used to simulate the Community first diagnosi s and two-way referral from the perspective of stakeholders.Simply increase finan cial subsidies,the Community first diagnosis rate will increase in the range of 0%-3.7%.Increase financial investment,while increasing the rate of family doctors signed,the Community first diagnosis rate will increase in the range of 0%--14.5%.Increase financial input and increase the rate of family doctors signed and inc rease the ratio of cross class visits to pay,Community first diagnosis rate will incr ease in the range of 0-91%.Simply increase financial subsidies,downward referral rate will increase in the range of 0.57%-2.60%.Increase financial input while i mproving the referral system,downward referral rate will increase in the range of 17.61%-35.42%.With the increase of the level of medical technology in primary medical institutions,the upward referral rate will decline slowly.Increase in the a vailability of medical treatment,the upward referral rate will rise slowly.Policy recommendations are as follows.Firstly,multiple strategy implements s hould be used to promote the community first diagnosis rate.Secondly,Improve t he two-way referral mechanism to promote downward referral rate.Thirdly,the he alth and Family Planning Commission play the main role of promote the constructi on of Medical Consortium.At last,reference to the international experience,Medi cal insurance reimbursement differential strategy should be implemented.