Study On Medical Security Index Accounting Management System Base On The Total Budget Of Third Grade Class A Hospital

Objective:By collecting Changchun City, Jilin Province four Third Grade Class A hospitalsprovincial insurance patients hospitalized costs related data since2012, contrast datafor the year2012,2013,2014, to evaluate the effect of the total budget, aims toestablish an appropriate accounting system for hospital insurance index, encouragedepartments rational use of insurance amount. In the case of medical quality assurance,promote the development of a better hospital.Methods:This study is to understand the current status of medical insurance throughliterature research, and the status of the total budget implementation. Usingquestionnaire survey, look into hospital managers, hospital staff, patients’ awarenessand satisfaction with the total budget. Using the Delphi method to determine theindicators of the total budget and determine the weight; Based on the newlyconstructed index system, establish insurance indicators distribution model.Results:Hospital costs: A hospital trips, the total cost of increased year by year, therelative decline in B, C, D hospital. Medicare reimbursement and expense accountinginversely; The average hospitalization days of each hospital change is not obvious, notdue to the implementation of management and reduce the total. The drug accountedfor each hospital in a small range of small range floating. The cost of treatment, fourhospitals were diminishing, and changed little.Awareness and satisfaction with the situation of the total budget analysis:Managers believe that the main advantage of the total budget is manageable medical insurance, control medicare costs increased, the main drawback is caused by doctorsrefuse severe patients. Most managers of hospital index exceeded, but still have halfof the managers to accept this mode of payment, at the same time that the need tostrengthen the insured person to the policy understanding and responsibility. Medicalstaff awareness of the total budget management policies generally higher, however,their satisfaction with the total budget were overall general. Patient awareness of thetotal budget is not high, only5.9percent of people have heard of "the total budget".Using the Delphi method to determine the total budget for Medicare accountingindicators system, to determine the4-level indicators, eight secondary indicators,24three indicators.Conclusion:(1)Based on the2012-2014accounts indicators, four hospitals with a totalbudget original fundamental basis of management experience to run the program,there is no strict scientific accounting methods. In the early running total management,hospitals did not understand the connotation of management, only limited restrictionstreated patients and control costs, common method is to increase the proportion oftheir own expense, in order to reduce medicare reimbursements. But with runningdeep, began to strengthen cost control, the main control unnecessary spending, such asmedicine, treatment fees.(2) The total budget for health care awareness of better management of patientswith this poor cognition.(3) When building health care management evaluation system, experts believethat health care costs and the scientific management of the Department critical related,should pay attention to the objective index of health care costs; The patient hasrelatively low autonomy in medical services, to supplement their lack of expertperception of relative neglect subjective indicators associated with increasedevaluation content. Hospital health care managers, insurance agency managers mainlyrely on practical experience, university experts focus on theoretical analysis. By two expert advice, data analysis, and ultimately determine indicators: an index4,8secondary indicators, three indicators25.(4) Comprehensive health care costs accounting system mathematical model.