Application Of Hospital Amoeba Model In DRG Payment Environment

Today,China’s urban and rural residents’ medical insurance system has basically achieved comprehensive coverage,and people’s lives and health are effectively protected;however,the gradually large medical insurance system has also brought serious problems to the operation of medical insurance funds,in order to guarantee the financial security of China’s medical insurance system,eliminate the waste of medical resources and reduce medical costs,in order to maintain the long-term balance of medical insurance funds,DRG(Diagnosis Related Groups)payment method was born in this context,and the DRG payment method is designed to standardize the use of medical resources by setting the medical insurance payment standard for each diagnosis related group,so as to reduce the burden of medical insurance fund,and at the same time,encourage hospitals to control medical expenses and reduce the waste of medical resources.As the reform of the health insurance payment system continues to advance,China’s public hospitals have begun to explore ways and means to ensure the public welfare of hospitals while maximizing efficiency.In this context,with the wide practical application of amoeba model in China and the continuous improvement of related theories,it becomes more and more feasible and necessary to study the application of amoeba model outside of enterprises.As an operation management model that can improve the efficiency of organization operation and realize the refinement of cost management,the amoeba model can be a direction and idea for hospitals to adapt to the reform requirements in the DRG payment environment.Taking Tianshui X Hospital as an example,the article analyzes the obstacles encountered by the hospital to seize the opportunity to achieve sustainable development in the context of DRG payment reform and the feasibility of applying the amoeba model,from dividing each amoeba unit within the hospital,constructing DRG payment-based amoeba settlement operation process and internal price transaction mechanism,unit time accounting mechanism and DRG-standard clinical pathway hospital amoeba unit cost control mechanism.It provides a feasible way of thinking for public hospitals to adapt to the needs of the times and respond to the changes in health insurance payment methods.It provides a feasible way of thinking for Chinese hospitals to improve their operational efficiency under the reform of the health insurance payment system,how to effectively carry out refined cost control,how to stimulate the internal vitality of hospitals and how to make each department take the initiative to It provides a solution to the problem of excessive proportion of drugs and consumables in revenue,and also contributes to the localized application research of the amoeba model in China.