Study On The Implementation Effect Of The Basic Medical Insurance For Remote Medical Treatment Direct Settlement Policy In Guangdong Province

1 ObjectiveTo understand the effect of the basic medical insurance for remote medical treatment direct settlement policy in Guangdong Province,and find out the problems existing in the policy,to make corresponding suggestions for improving the policy,by studying the relevant theories of remote medical treatment,analyzing the current situation of remote medical treatment in Guangdong Province,conducting questionnaire surveys on remote medical treatment staff,staff of medical institutions designated for remote medical treatment,and staff of medical insurance agencies,and combining the results of interview in some cities in Guangdong Province.2 MethodsThis study adopts the methods of theoretical research,policy study,current situation analysis,questionnaire survey and interview to study the implementation effect of remote medical treatment direct settlement policy in Guangdong Province.3 ResultsThe direct settlement platform for medical treatment in Guangdong Province was launched on October 28,2015,as of September 7,2018:(1)A total of 1.61 million person-times of direct settlement of remote medical treatment in Guangdong Province.The medical expenses for direct settlement of remote medical treatment were 38.1 billion yuan.The expenditures of medical insurance funds for direct settlement of remote medical treatment were 20.4 billion yuan.The average hospitalization expenses for remote medical treatment was 24,000 yuan.There are 782 designated medical institutions for remote medical treatment.(2)After the remote medical settlement platform in Guangdong Province was launched,the person-times of direct settlement of remote medical treatment and the expenditures of medical insurance funds for direct settlement of remote medical treatment showed an increasing trend.(3)The distribution of medical resources in Guangdong Province is uneven,and 75.0% of the remote medical treatment is concentrated in Guangzhou,where medical resources are abundant.(4)All sectors of the society have high satisfaction with the direct settlement policy for remote medical treatment in Guangdong Province.The satisfaction rate of medical insurance participants is 84.0%.The satisfaction rate of staff in designated medical institutions for remote medical treatment is 86.8%.The satisfaction rate of medical insurance management staff was 88.3%.Existing problems: the distribution of medical resources is uneven,the sporadic reimbursement rate of remote medical treatment needs to be further reduced,the "three directories" need to be unified,the policy awareness needs to be further improved,and the release of remote medical treatment brings pressure on medical insurance fund.4 Conclusion(1)The implementation effect of the remote medical treatment direct settlement policy in Guangdong Province is generally good.The departments of medical insurance management of various cities actively respond to the livelihood project.A large number of medical institutions at all levels actively participate in the construction of settlement system of the remote medical treatment and connect the provincial remote medical management platform.The number of insured people benefiting is huge.(2)Members of the community have high satisfaction with the policy of direct settlement of remote medical treatment in Guangdong Province.The satisfaction rate of this policy is higher at remote medical treatment staff of medical insurance,staff of medical insurance agencies and staff of medical institutions designated for remote medical treatment.(3)In the process of implementing the policy of direct settlement of remote medical treatment in Guangdong Province,there are some areas that need further improvement.