Satisfaction Evaluation System Research For Medicare Patients In Case-based Payment

The Background of ResearchBasic medical insurance in xiamen has implemented some diseases by the Case-basedPayment in July1,2005formally, which has been nine years. With the kinds ofCase-based Payment improving from8to the21now, Case-based Payment wasalways developing and perfecting constantly in practice.Yet patients of Case-basedPayment is satisfied or not with the operation of the health and medicalinstitutions,which still lacks of professional and reliable assessment tool.Commentsand suggestions of the patients were difficult to get feedback.Related research about Case-based Payment on abroad or domestic shows thatCase-based Payment was able to control the speed of medical expense form rising,effectively reduce the average hospitalization days and cost,which may improve theimprovement and service management for hospitals. Then the hospitals will try tobalance the use of health care costs, which ultimately improves the medical servicequality to a certain extent. But whether those improvement or settlement can get thesupport from patients and whether effectively improve the economic benefit orcontrol, in order to obtain the desired social benefits at the same time, still lacksrelated research and policy support. Exploring for Case-based Payment with healthcare reform, the ultimate goal should be service patients and the people.Research purposeThe purpose of this research lies in the comprehensive evaluation of xiamen’s tertiaryA hospitals in Case-based Payment implementation effect, analysising the advantagesand existing problems in Case-based Payment.Then suggestions to consummate theCase-based Payment mode of medical treatment insurance scheme should be comeout. The research content(1) Preparation of Case-based Payment satisfaction questionnaire, then we use thequestionnaire as the satisfaction of Case-based Payment research system of theprimary tools;(2)Through the patient satisfaction survey for xiamen Case-based Payment data, tomaster the influencing factors of satisfaction;(3) With the data, this paper analysis on the problems existing in the system designand implementation process, summarized the existing deficiencies in the study.The research methods1, Document retrieval and nformation accessPayment method of Case-based Payment satisfaction literature at home and abroad,collect relevant documents in the city policy data, understand the country and xiamencity files, basic medical insurance system, policy and the implementation ofCase-based Payment plan.2, Field investigation(1) Important insider interviewWith the method of important insider interview, understand the Case-based Paymentformulation of objectives, project implementation process and results, confirm factorsand dimensions associated with satisfaction. Interview objects including health carecenter staff, health center and settlement office staff, research hospital executive incharge of the dean and health care workers.(2) Satisfaction questionnaireThrough literature review and expert consultation method, determine the satisfactionrelated metrics and dimensions.According to the American customer satisfactionindex (ACSI) model and the Chinese hospital patient satisfaction index model(CHPSI-05), and the elements of establishment for Case-based Payment satisfactionquestionnaire were analyzed.Then fill the questionnaire into2groups, telephonefollow-up group and field investigation group,which including30~40patients forpreliminary investigation, Comparison and test the reliability and validity of the questionnaire, through the retest reliability index to choose the right means ofinvestigation.Then modify the selected questionnaire after supplement,randomsampling investigation will be start in the intern hospital, sample size about300, withsatisfaction questionnaire survey, to understand the inclination of the patients to thecurrent Case-based Payment operation of cognition and satisfaction.The results of the study and the main findingsTelephone follow-up survey are suitable for the Case-based Payment patientsatisfaction survey; Patient satisfaction evaluation is differ, but the high level and thesense of responsibility of medical evaluation get a high mark,then timeliness andservice attitude should be improved; Patients and their families of Case-basedPayment of cognition is not enough, there was still considerable deficiency ofknowledge; Case-based Payment operation on the patients with party’s participation isinsufficient, lack of formal satisfaction feedback system; Enhance the level of medicaltreatment is the key guarantee satisfaction.Policy SuggestionsTo improve the satisfaction of Case-based Payment research1. Conduct joint research, share the resources2. Expand the research time, get different diseases into account3. Increase the propaganda dynamics, properly use of social powerSuggestions for Case-based Payment system itself1. To establish a professional satisfaction evaluation feedback system2. We will improve the mechanism of the current cost accounting3. Strengthen the communication with patients4. Avoid the risk of the hospital transfer5. The organic combination of clinical pathway with single disease payment...