A Study On The Influence Of The Medical Insurance Agreement Management Mode On The Irregularities Of Public And Private Hospitals In District Y Of X City

The 14th national congress of the communist party of China in 1992 and the third plenary session of the 14 th central committee of the communist party of China in 1993 made clear the goal of the market-oriented reform of the economic system.With the adjustment of the relationship between government and enterprises,the establishment of the enterprise system in state-owned enterprises and the rise of a large number of non-state-owned economies,the establishment of the modern medical insurance system was put on the agenda.From 1994 to 1998,the pilot work of the employee medical insurance system was successfully carried out.China’s medical insurance system was established in 1999,and it has only been 20 years since then.During this period,China has gone through the transformation of social structure,the transformation of economic system,the adjustment of interest pattern and the transformation of social concept,etc.,and the original public medical system has lost the theoretical and practical basis for its continuous existence.The new medical insurance system is based on employee medical insurance and resident medical insurance.There are few studies on the management of medical institutions by the medical insurance department,which will also affect the operation efficiency of the medical insurance fund.From the perspective of the medical insurance administration department,this paper analyzes and studies the current management system from the actual management level,and puts forward Suggestions for improvement.This paper first introduces the international management mode of medical institutions under four different medical insurance systems,and makes corresponding evaluation,and then leads to the agreement management mode in China.By focusing on the data of public hospitals and private hospitals in District Y of X City from 2014 to 2018,it is found that the binding force of agreement management on private hospitals is lower than that on public hospitals.This paper analyzes the reasons from the objective conditions of the hospital,the nature of the medical insurance agreement and the constraints of the insured patients,and puts forward corresponding solutions.Finally,some Suggestions are put forward to guide hospitals to standardize their behaviors,include medical insurance agreements into the scope of administrative contracts,and restrict medical insurance from the perspective of insured personnel,which is of certain reference value to the policy formulation and selection of relevant departments.