The Impact On Diabetes Medical Expenses Of Capitation Payment Reform

The Medical Insurance fund is facing the challenge that the diabetes medical expenses growing rapidly. It takes 13 percent of total public health expenditure in 2013 to cure diabetes and the related diseases in China. It is the very time that China implemented the second round medical insurance reform, which aims at slowing down the rapid growth of medical expenses, balancing the medical insurance fund income and expenditure. Based on the domestic and oversea experience, payment reform is effective at declining the medical expenses. It comes out that the payment reform is the key point.This thesis analyses expense changes in seven months during the reform carried out. The total medical expense was up to 2001.17 Yuan per capitation in Janua ry. It went down to 1305.33 Yuan in July. The expense for each patient went down in two or three months apparently and then went steady afterward if they contracted with S hospital. In this way, the reform works in decreasing the increase rate of medical e xpenses. This article made quantitative analysis of the average expenses monthly, such as descriptive statistics and correlation, grouped by doctors, contracting date and sexuality by the use of SPSS 19.0. The following three conclusions are proved. Firstly, there is a negative correlation between the average monthly expenses and contraction date. In other words, the later the patients contracted, the lower his medical expenses cost. Secondly, the reform did not work in the community hospitals. Because the revenue and the expenditure of the community hospitals are separated, the capitation payment reform is not feasible in community hospitals. Thirdly, the age is the uncorrelated factor, and the gender is the correlative factor. The expenses of the female patients are higher than those of the male patients, and the expenses of female patients are much hard to control.Based on the capitation payment reform, this article put up with five pieces of experience in future diabetes case management. Firstly, complete the top design; Secondly, build competitive doctor management system; Thirdly, carry out market reform in medical industry; Fourthly, build Management Information System for medical service; Fifthly, develop diabetes education.