Research On Optimization Of Medical Cost Control In HD Hospitals Under DRG Payment Reform

Under the background of economic development and aging population,residents’demand for medical care is increasing day by day,and medical insurance funds may face huge risks with the rise of medical expenses.The main reason for this phenomenon is that the charging system by item implemented by hospitals in our country for a long time has unreasonable consumption items,which makes medical expenses show unreasonable growth.To change this situation,the state has vigorously promoted the reform of diagnosis related groups(DRG)payment method,which has brought pressure to the survival and development of hospitals,and improved the control of medical costs.Firstly,this paper sorted out the relevant documents and summarized the requirements of DRG payment mode for hospital medical cost control by using the method of literature research.Then,the current situation of medical cost control between HD hospital that had not implemented DRG payment and DS hospital that had implemented DRG payment was compared and analyzed by comparative analysis method.The simulation DRG settlement was carried out for HD hospital,and it was pointed out that the characteristics of DRG payment "surplus retention" force hospitals to control medical costs.In addition,this paper compared the differences between the current determination method of medical cost under the DRG payment mode and the previous payment according to items,and combined with the cost control theory and incentive theory,to analyze a series of problems such as imperfect medical cost control system,imperfect system and accounting in HD hospital at this stage.On the basis of the above analysis,suggestions and improvement measures with wide applicability were put forward for the optimization of HD hospital cost control under DRG payment mode,such as perfecting budget management system,optimizing medical cost control system,implementing DRG disease composition accounting based on activity cost,and bringing DRG disease composition control into performance evaluation,etc.The following conclusions were drawn through analysis:DRG payment was the mainstream trend of hospital payment reform,which would have a certain impact on hospital medical income and cost,and "surplus retention" was the main reason for the impact of DRG payment on medical cost and income.The research of HD hospital showed that under the current shortage of financial investment and DRG payment reform,hospitals needed to change the previous concept of "income-generating first" and attached importance to the control of medical costs in order to maintain its public welfare nature and provide high-quality services to patients.