Study On Implementation Of Financial Compensation Policy And Countermeasures Of Various Medical And Health Institutions At All Levels In China

ObjectivesThe purpose of this subject is a comprehensive summary of the medical and healthinstitutions of our country at all levels of financial compensation policies and theirimplementation, summed up the problems in the implementation process, and analyzethe reasons for the problem. According to deepen the medical and health system andsanitation, and sustainable development is the need to put forward further reform ofhealth investment policy recommendations.MethodsBy Literature inquiries, informant interviews and Annual Financial Information ofHealth to obtain hospital financial compensation-related information, on this basis,analyzing Quantitative data in quantitative way. Processing qualitative datascientifically for expert advisory data and interview data.ResultsThe implementation situation of public hospitals (including urban hospital, CountyHospital, hospital)：urban hospital infrastructure fund grant income is less than theexpenditure, gaps of about656.6998million Yuan, capital subsidies has not yetcompletely in place, County Hospital and hospital infrastructure subsidies arebasically in balance, to implement a policy in place. Urban Hospital, County Hospital,in the hospital on retired personnel funding of compensation policy are not full ofimplementation, in2010,the urban hospital on retired personnel only grants had itsactual spending of68.05%, financial grants and actual spend was gap for3.7451billion yuan, County Hospital on retired personnel only grants had its actual spendingof70.99%, financial grants and actual spend was gap for1,074,660,000yuan, in the hospital on retired personnel only grants had its actual spending of68.84%, financialgrants and actual spending was gap for$802.7655million yuan. The policy of healthloss is also not implemented to public hospitals, most of hospitals put compensationas person or beds. Financial compensation of the public health policy is far from beingimplemented to public hospitals, they have not relies on fully responsible for financialcompensation of public health services, urban hospital health financial assistance only41.22%of health care expenditures, county hospital health financial assistance only53.27%of health care expenditures, hospitals in prevention and health care financialassistance only44.55%of health care expenditures.To the development of importantdiscipline, The implementation situation that Government designated emergencytreatment, foreign aid, agriculture, assist public service compensation funding projectslarger differences in various regions, it mainly depends on the financial situation oflocal government and the foundation of the hospital itself.The implementation situation of primary health sector (including community hospitalsand rural hospitals)：In2010, basic fund income and expenditure of communityhospitals and rural hospitals were balance, the implementation situation of the policyabout basic fund compensation to them was good.For basic expenditures such asprimary health sector funds poor implementation of compensation policies, in2010,community hospitals and rural hospitals basic finance expense reimbursementrevenue accounted for basic expenditures respectively,18.3%,19.42%，it was lowlevel, not through financial meet their spend on basic need. Community hospitals andrural hospital are not full compensation to health service that they meet, but the levelof compensation is higher, in2010,the financial compensation of community hospitalwas accouted78.58%，and the others was accounted64.12%.The implementation situation of major public health institutions (including healthsurveillance, disease prevention and control, maternal and child health care, bloodcollection and supply institutions)：Development and construction expenditures of thehealth surveillance, disease prevention and control, maternal and child health agencies,blood banks infrastructure capital expenditure of financial assistance expenditureswere less than required for basic construction, equipment procurement by theGovernment under the Public Health career development needs the full amount fiscal policy may not be implemented. Health oversight agencies financial expenditure in2010of financial assistance revenues accounted for basic expenditure ratio was84.18%, the full government budget to arrange funding for the necessary personnelcompensation policies are implemented is better. Financial assistance income indisease prevention and control financial expenditure in2010accounted for basicexpenditure ratio was52.84percent, the government budget in full to arrange fundingfor the necessary personnel compensation policy implementation in general. Financialassistance in maternity and child care financial expenditure in2010income accountedbasic expenditure ratio was23.80%, the full government budget to arrange fundingfor the necessary personnel compensation policy to implement the low level. Bloodcollection agencies financial expenditure of grant revenue in2010accounted for basicexpenditure ratio is only15.63%of the full government budget to arrange funding forthe necessary personnel compensation policy for the implementation of the low level.Project of public health agencies’ compensation payments is balanced, therefore thegovernment is full to arrange the necessary public funding and operational funding forthis compensation policy is to implement the better.DiscussionFirstly, discusses the various types and levels of medical and health institutionsfinancial compensation problems in the implementation of the policy process, first,the scale of financial investment is still insufficient. Secondly, the implementation ofthe "footsteps slow, can not keep up, in some places due to local circumstances, theimplementation lag can not be synchronized with the national policy. Thirdly inputstructure is irrational, and some economically developed regions the emphasis oninfrastructure and equipment acquisition, and ignore the investment in public health.Fourthly, lack of government subsidies for hospital personnel expenditures. Fifthly,the compensation of county level and above the county level hospitals still operatingincome-based. Sixthly, the specialist hospitals put into the implementation ofpreferential policies may not be implemented input policy-medical loss based uponthe original investment in the way. Seventhly, the Government of the maternity andchild care compensation "Absent", personnel expenses have not been to protect theservices to carry out heavy clinical light care. Summary of financial compensation for the implementation of policies andimplementation of the possible reasons for the emergence of various problems,grouped into the following. First, the local fiscal capacity to a certain extent restrictedthe implementation of the policy, resulting in differences between regions. Second,some local governments is not enough impact on the health degree of attention theimplementation of the policy. Second, the contradictions between the results to thehealth needs of the health investment. Third, macro-policy has led to theunderstanding of the investment by all levels of government, particularly the financialdepartment of the government health policy is not clear enough. Fourth, the absenceof scientific performance appraisal mechanism, supervision and evaluation of the useof funds is not standardized.RecommendationCompensation policy formulation and implementation of the health institutions ofvarious categories of all levels of financial problems, the following policyrecommendations, in order to better improve the financial compensation for policyformulation and implementation to achieve the effects of policies: With mythimprovement of the public finance system should be established to the health systemof public finances, in order to protect the sustainability and stability of governmentinvestment; the development of leadership, emphasis on investment in health; tofurther clarify the responsibility of central and local governments for health inputs,improve health fiscal transfer payment system; clear functional positioning of thevarious agencies at all levels, reasonable estimates for the costs of implementationaccording to the function, provide the basis to determine the input criteria and inputdirection; the development of investment policy of the relevant supporting documents,a clear government investment-related issues to facilitate the implementation of localgovernment; to strengthen government health input monitoring and evaluationmechanisms.