Pricing Of Medical Service Under Single Disease Management

Recently,in order to prevent the development of "medicine to medicine","medical instrument to medicine" phenomenon in medical industry,the government take vigorous measures to solve the difficult problem "expensive medicine care",such as carrying out the zero rate policy of medicine,price reduction of using large equipmentand so on.At present,the income structures of medical institutions experience a huge change,and they urgently demand a payment method that can compensate the cost of medical services.While the present single charge mode by service items cannot measure the value of medical services effectively,and this charge mode is far from building an effective incentive and restraint mechanism.Thus,a demand for new payment method is imperative.International experiences show that the payment method in which the pricing unit is disease group plays an active role in controlling medical expenses,optimizing the medical competition environments,improving the quality of medical services and so on.Up to now,the government introduced a series of relevant policies,confirmed the importance of payment by disease and the possibility of implementation in our country.Hospitals make a preliminary attempt and exploration of this new payment according to the relevant policy statements and actual situation.In this work,we investigate the pricing method by single disease and related issues in the view of economics.First,sorting out the evolution paths of the medical services charges are shown as follows,from the initial medical charges which is chartered as the income of medical workers to "piece charges" which is charged as service items,from charges by each person focused on health care and prevention to introducing "clinical pathways" which is charged by diseases,and the mixed charge system concerning complicated realties.For the medical services exhibiting several paying methods,choosing proper paying method not only influences treatment efficiency,but also the relationship of doctors and diseases.The,we investigate the development path of paying methods for representative countries,such as America,England,Japan,Germany,and Hungary.At last,the implementation necessity of single disease in our country is investigated.We think that the single disease is needed to be strengthened due to the unreasonable medicine pricing method,the change of compensation mechanism under "the separation of doctor and disease"policy,the promotion of the clinical path,the information asymmetry of the Incentive and restraint mechanism.Based on current research situations,we analysis the payment problem of single disease in two aspects which are demand and cost.In the demand level,the Ramsey-Blatter pricing model is introduced with boundary cost pricing in ideal situation.There exist cross subsidy problems in this model,and seeking welfare maximization in Ramsey pricing structure is investigated in the range of no subsidy price.In the cost level,the disease is priced based on the perspective of cost sharing,which is in the view of principle of cost attribution.Then,the complete dynamic game of information between government and hospital is built with the game relationship of government,hospital and disease.Next,incentive and restraint model is established by incomplete dynamic game of information.We investigate the impact of the behavior of seeking maximize utility in hospital on disease in the situation of incomplete information and asymmetry,and analysis decision and constraint conditions of incentive and restraint mechanisms.Finally,some advices are proposed about incentive and restraint mechanisms reform between hospital and disease.In conclusion,single disease pricing mode can relieve the problem of price cross subsidy in a certain situation.Artificial charges are in a leading position in single disease pricing mode,which reflect the core value of medical services and agree with the law of value.The financial compensation from artificial charges is more motivated than that from government.The single disease pricing mode inhibits"medicine to medicine","medical instrument to medicine" phenomenon in medical industry and specifies medical behavior.In addition,"single disease charges" fairness in cost sharing for disease,and this payment method improves the method "charges of service items" of our country in the current stage,which is important in building effective incentive and restraint mechanism between hospital and disease.The"single disease charges" agree with establishing a multi-compound payment system of our country at the present.