Research On Chinese Medicine Service And Hospital Compensation Mechanism

一、 Research BackgroundAt present, the difficulty of getting medical treatment becomes a hot health care issue, even prominent social problem in China. The new medical reform program is to reduce medical expense burden and solve the Problem of the difficulty in seeing a doctor and the high cost of getting treatment. Public hospital of the market turn reform, the in expiation of mechanism of "keep to cure by medicine", public hospital tend benefit tendency, cause the not reasonable growth of medical expense. Therefore, the solution need develop low expenses and the reach of good medical and health service. On the other hand need to get rid of to compensation with the hospital that the medicine keeps to change public hospital tends benefit motive.After several thousand years of development, the adaption of the Chinese medicine had by its wide and medical cost low and easy expansion applied the etc. advantage have already got a full proof. Chinese medicine service item has in brief, convenience, accurate curative effect special advantage, have a showing of simple, cheap, feasible characteristics.The Chinese medicine hospitals are platform of Chinese medicine culture and provide the importance of Chinese medicine service to carry a body. Currently, the Chinese medicine hospital westernization phenomenon severity, mainly because the government isn’t reasonable to method in the compensating of Chinese medicine hospital, the national public finance gives of the subsidy is opposite less, Chinese medicine he price Be opposite and cheap anti-to pour to become the soft rib that the medical baffling Chinese medicine organization develops.The current compensation of public hospital has three main methods:The first is financial compensation. The second is medical services income and the third is drug profits. Financial compensation means the government provides hospitals with one-time investment and budget subsidies. Financial compensation can control the society medical fees, and make the low-income people be more equitable access to basic medical services.And so, this study tries to analysis the typical situation and status of public hospitals, understands the practical effects of the current compensation policy, finds out the problems, and gives the policies suggestion for adjusting and improving the public hospital compensation mechanism.二、 Research ObjectiveThis research purpose is with deepen medicine health system reform for background, analyze repair absurdity in the Chinese medicine development predicament and hospital through theory and substantial evidence of realistic problem, with government public finance devotion and medical service price adjustment is lord line, adopt a repair policy intervention in the system dynamics establishment hospital to imitate to test platform, and adopt cost to check a method to set up a hospital to acquire economy in expiation of data foundation, put forward have already aimed at an in expiation of policy suggestion of strong hospital of possibility, direction function pass a policy, promote our country Chinese medicine business of can keep on a development.三、 Research IdeaThis studying for Chinese medicine to serve and the hospital compensates a mechanism and passes into a relation according to the logic and one by one in order elaborated to study the theory foundation for applying. Clarified the method made use of for winning research to learn and it the research make progress. Analyze Chinese medicine service faces of present condition, diagnose the predicament of Chinese medicine development, put forward to promote the strategy that the Chinese medicine develops. From our country the economy luck camp current conditions in hospital analysis commenced and looked back our country hospital compensate the reform process of mechanism, announced to public to public hospital compensated the problem of the mechanism existence, regard medical service price repair and the government public finance devotion as principle line, from the tiny view and macro view two paths to studied in expiation of mechanism in the hospital of perfect with correction, the tiny view level adopted standard cost to check the public finance devotion and medical service price compensated to the popular solid government of data foundation, the macroscopic level made use of system dynamics model to imitate true intervention policy of usefulness, put forward the policy suggestion that the homologous improvement hospital compensates a mechanism thus.四、 Research MethodologyThis text mainly adopts theory research and substantial evidence research to combine together and settles quantitative and qualities a research. Analyze in the norm in, build up the system dynamics mathematics model, launch to the different corpus in the relation analysis in the game, imitate the effect of dissimilarity intervention policy, put forward the suggestion of repair policy in the hospital. The statistics data that adopts case analysis our country medical service industry announces to public the problem of in expiation of mechanism absurdity in the hospital. The substantial evidence analyzes the related data of sample Chinese medicine hospital and check actual cost elucidation hospital repair the existent price is lower than the problem of cost, check in the middle of the mechanism the standard cost serves for the medical treatment according to the cost to draw up the public finance burden policy of price and government deficiency to provide basis.(一) References Review and AnalysisOn the foundation of cultural heritage data checked, carry on inducing to the main standpoint in each kind of cultural heritage data towards having same research purpose many research with independent results to carry on a comparison and synthesizing analyzing,.Inducing can draw lessons from of theory and method, and definitely the theory innovation of this research orders to probably particularly break with studying of direction.(二) System analysisThe so-called system means to constitute to some main factors of each other contact a mutual check and supervision again, for carry out a common target but existent of organic aggregation. The basic principle that talks about according to the system, this research the hospital compensate the system see make a system, from more macroscopic angle, more overall, more objectively the certain hospital compensates a not reasonable mechanism.(三) System dynamicsThe main characteristics of system dynamics is to expediently handle line not and change phenomenon, can do long-term of, dynamic state of, strategically imitate true analysis and research. The research method establishment hospital that makes use of system dynamics compensates the system dynamics of mechanism model and pass model emulation as a result carry on correction to the model, finally carry on the intervention experiment of repair policy in the hospital, for perfect public hospital compensate the mechanism put forward a policy suggestion(四) Cost AccountingThis literary grace is been checked method to measure the actual cost and standard cost of calculating the medical service item with the cost, passed the margin of more analytical item actual cost and charges and announced to public the reason of deficiency in the hospital and the absurdity of the repair mechanism. Passing more analytical standard cost is a hospital to control cost and lifts high-efficiency and reasonable list price to provide basis, finally acquire reasonable public finance subsidy and medical service price repair to provide science for the hospital basis and data support(五) Stock Holder AnalysisThe research makes use of a benefits’ related theory various benefits from the medical and health realm is related, like government, hygiene, commodity price, public finance, cure to protect, in the drugs, medical communities, such as organization etc., and make sure a key benefits that hospital compensates related. Analytical key benefits the benefits tendency of the related, from moderate corpus benefits relation of the angle design an in expiation of mechanism, can contribute to solution to public hospital compensate the essence problem of mechanism.(六) Cost Benefit Analysis (CBA)This research use cost benefit analysis method, study a disease to grow a homology, the condition is close by, obtain the circumstance of end treatment effect under, adopt a Chinese medicine treatment method and adoption doctor treatment way, the treatment expenses cost by sufferer, have price cheap advantage with on display medicine service of currency from the economics, thus proof development Chinese medicine service of importance.(七) SWOT AnalysisThe development of Chinese medicine is subjected to an inside oneself condition, and the influence of external macroscopic environment various factor, internal and external factor is advantageous to pure Chinese medicine of the reason of system to develop with the analytical method of SWOT, the Yang is long to avoid short, draw up reasonable development strategy thus.五、 Research Results(One) The developing problems the Chinese medicine faces1. Westernization problem in the Chinese medicine hospital severity Under the market economy condition, because of service ability in Chinese medicine hospital shortage, compete in the market in be placed in a minority, adopt doctor service of high economic efficiency, cause doctor in the Chinese medicine hospital turn to incline to severity, Chinese medicine service of the position be gradually weakening.2. Chinese medicine special feature service provides to have atrophic trendIn medical service, the Chinese medicine hospital neglects Chinese medicine special feature specialty construction, the phenomenon of Chinese medicine special feature diagnosis and treatment item reduction. Seeing from grass-roots medical organization, majority of Chinese medicine special feature isn’t outstanding, the many Chinese medicines medicine traditional item faces a lost crisis.3. The need of Chinese medicine service is opposite to descend trendAccompany with market economy system reform, because of lack to correspond a supporting of kit policy and under the influence of factors like economic benefits, etc, the medical organization would not like to provide the Chinese medicine service, and the common people also lower gradually to the trust of the Chinese medicine, the Chinese medicine serves to make use of gradual decrease.(Two)The Chinese medicine develop strategy1. Set up to perfectly promote the Chinese medicine development policy system. The national policies all embody an explicit fixed position for Chinese medicine and guarantee in financial power, talented person’s development, feat technique expansion etc. all have an explicit request, and have homologous kit document and measure and have maneuverability and instruction and effectively promise and promoted our country the Chinese medicine serve of development.2.The Chinese medicine should ask for help of the community hygiene service organization development Chinese medicine service has the advantage of, can raise residents being within the reach of medical treatment service, feat develop in the community. Service principle and community health organization of Chinese medicine mutually fits together.(Three)The public hospital compensation mechanism faces problems1. Medical service price and cost deviateThe medical treatment ministrant charges don’t reflect manpower cost, the price neither reflects value nor reflects a supply relation. Exist in our country medical service price system various problem’s pricing up space is keep both higher and low. The price total level soars to distort with price keep both. Fee the empress and fee hike isn’t good enough keep both.2. The shortage of government public finance devotionOur country government hygiene expenditure expenses year by year increment, but the government expenditure part has all proportions of health expense but presents to descend trend. The proportion that the government public finance throws in the away below and flourishing national level even is lower than the nation of equal development level.3. Low fee coverage rate:the actual costs of the majority of the items exceed the curgent schedule of fees.The fee coverage rate of Chinese medicine special feature service item is lower than100%. All of purpose charges reflecting a Chinese medicine hospital are lower than actual cost, cause the policy of Chinese medicine services loss in business.(Four)The hospital compensates system dynamics model intervention policy experiment1. The income growth trend in hospital imitates reallyContinue and keep and cure by medicine" the movement of compensating the mechanism, public hospital of government subsidy the income will be more and more low in the proportion in gross earnings in the hospital, public hospital of "public welfare" is hard and embody.2. Medicine separately of the intervention policy experiment(1)The medicine separates the influence to receipt and expenditure in the hospitalPractice a medicine separate behind, if have no other paths and compensate, although gross earnings in the hospital and total expenditure can continue and keep and increase a situation, the hospital will appear huge owe debts, and loss in business a sum and pass and increase annually, existence in the hospital and development will face great influence.(2)The medicine separates behind the medicine fee have compare imitate really on trialThe medicine separates behind public hospital outpatient time all medicine fee and hospital discharge patient person all the medicine fee have compare all present gradual descendent of trend, descend of the range is very obvious, explain drugs use of frequency and amount will resume gradually reasonableness and reasonable.3. Increase the policy of government public finance devotion to experimentAlong with the aggrandizement of the government subsidy growth rate, be public finance subsidy the income have gross earnings proportion in the hospital to increase to25%or so, resume the level in the beginning of80’s in last century, the trend goes to the hospital over a long period of time basic can attain balanced budget.When the government throws in a growth rate under the35%condition, average level about match a national public finance devotion medical treatment of OECD, in addition to fore several year, the hospital will be placed in the deficiency of slight degree outside, public hospital on the macroscopic level can the need of basic maintenance steady growth.4. Raise medical service the policy of the price experimentThe small range raises technique service the influence of the price upon the hospital receipt and expenditure in hospital. Receipt and expenditure in the hospital is appearing deficiency for inchoate several years, but hereafter gradually from loss in business to turn a surplus. The adoption adjusts a medical treatment to serve pricing of strategy, have to definitely and first increase public finance devotion, transfer a medicine separate beginning stage of receipt and expenditure deficiency in the hospital.5. The combination compensates measure of the policy experimentThe government throws in a growth to lead to20.0%.The out-patient service cures a fee growth to lead to13.0%.Hospitalization cures a standard growth to lead to13.0%.Hospitalization surgical operation fee growth leads to13.0%.Government need not in a short time throws in large sum of public finance subsidy, medical service charges all be not significant growth, but comprehensive the policy effect can promise to public hospital maintain it to revolve as usual and healthily develop and change the in expiation of mechanism of "keep to cure by medicine" gradually thus.六、 Policy SuggestsThis study theory foundation and method need to analysis Chinese medicine service and hospital compensate the problem of mechanism existence, from the tiny view and macro view two levels to studied in expiation of mechanism in the hospital of perfect with correction, the tiny view adoption cost checked to perfect medical service price formation mechanism, the macroscopic aspect made use of system dynamics model to imitate true intervention policy of usefulness, put forward a following policy suggestion thus.(One) Special function that full exertion Chinese medicine serves.(Two)The cost building up hospital’s unifying checks system and enhances cost consciousness.(Three)The cost of building up the hospital checks information-based system.(Four)Build up budget performance evaluation system in hospital.(Five)lncrease the government devotion proportion, and raise the control dint of the government to behavior in the hospital.(Six)Speed medical organization to produce power and internal management system reform, build up the in expiation of mechanism of many outlets.(Seven)Carry out medicine separation, cut off with the money raising;, mechanism that the medicine keeps to cure.(Eight)Reform list price system in the hospital, adjust hygiene service price.(Nine)Perfect medical insurance system enhances third parties to purchase a mechanism.(Ten)Build up interaction mechanism in the hospital of sound function in the community hospital and layer class, carry out a resources excellent turn an allocation.