Research On Supervision And Management In The Appointed Medical Institutions Of New Rural Cooperative Medical System

The current situation of the supervision for the appointed medical institutions of new rural CMS in the sample counties and cities is investigated to analyze the existing problems and the adopted strategy and measures. The distribution of the unregulated actions and the unreasonable charges in the areas of medicine, examination and charges will be analyzed in the appointed medical institutions of new rural CMS to offer the related data and to be used for reference for the supervision to the appointed medical institutions of new rural CMS and to ensure the lasting development of the new rural CMS. Method: Five experiment counties (cities) are singled out as the investigation spots from the first experiment units in the Anhui Province according to the economical levels to investigate the general situation and the current situation of the supervision on the sample counties (cities). Self-made syllabus of interview are applied to the principals of the appointed medical institutions, doctors delegation and functionary director general of the board of health, the stuff who runs the related institutions and peasants delegation through the specific interview or group discussion. Two county-level and two country-level are taken out from every county. The self-made questionnaires are adopted to select the participated cases and non-participated cases according to the types of diseases. Quantitative analysis and estimation are applied to the existing unregulated actions and the unreasonable charges. Result:①The main problems of the supervision on the appointed medical institution are the administrative system, the construction of capacity of medical institution and undertaking institutions, the unregulated actions and the charge control, the supervision to the medical institution outside the county.②The condition and principle of the admittance of the medical institutions of new rural CMS similar to the medical insurance in the city. The procedure of the admittance consists of proclamation, application, checkout, and promulgation of the result.③The strategy and measurement of the supervision involves the establishment of various kinds of policies and the application of different measures to strengthen the supervision to the appointed medical institutions.④Excessive medicine application and unapproved charges are the most serious unregulated actions. The numbers of participated cases' unregulated actions are more than those of non-participated cases, the counties more than countries.⑤Among the unreasonable charges, the charge of medicine amounts to 62.7%, the charge of diagnosis and treatment 10. 4% and the charge of material 5.9%. The county-level's unreasonable charges are higher than those of country-level. Conclusion: The policies should be regulated and all kinds of the formal and informal principal bodies of supervision should be allied. The supervision of charge control and unregulated actions of the appointed medical institutions of CMS should be strengthened. Different methods should be applied to the supervision to the appointed medical institutions. Excessive medicine application and unapproved charges are the most serious unregulated actions. The appointed hospitals' unregulated actions differ from each other due to the different patients and cases. Of all the unreasonable charges, the charge of the medicine is the most serious. The county-level's charge is higher than that of country-level.