Research On The Current Situation Of Disease Score Payment (DIP) In County-level Public Hospitals

Research background;By the end of 2020,China officially entered the pilot stage of payment by disease score(DIP).County-level public hospitals undertake the heavy responsibility of medical services within the county level,and are also the weak link of China’s medical service system.They face great challenges in the implementation of DIP.How to seize the opportunity and break through the dilemma in the reform of medical insurance payment to make the county-level public hospitals achieve sustainable,healthy and orderly development deserves our attention and discussion.Study objective:Taking a county-level public hospital in the pilot city(Dezhou city)as an example,the challenges brought by DIP to county-level public hospitals were analyzed,and the current situation of X Hospital was analyzed through SWOT and proposed.In the analysis,field survey,including questionnaire survey,qualitative interview and statistical analysis,were adopted.From the qualitative and quantitative perspective,analyze the requirements of DIP brought to county-level public hospitals and clinicians,and conduct targeted investigation and analysis on the current situation of DIP implementation in X Hospital and clinicians’ cognition of DIP and execution willingness.Finding:1.DIP puts forward new requirements for county-level public hospitals and clinicians:fine management of diseases,medical technology level,quality supervision,clinical path,information construction,hierarchical diagnosis and treatment;clinicians include the cognition of medical insurance payment method,specification of medical behavior,quality of medical record filling,and information management of department cost.DIP puts forward new requirements for county-level public hospitals and clinicians:fine management of diseases,medical technology level,quality supervision,clinical path,information construction,hierarchical diagnosis and treatment;clinicians include the cognition of payment method,specification of medical behavior,quality of records,information management of department cost,etc.2.Operation of DIP in Dezhou X Hospital:perfect hardware facilities,medical technology to support in several superior hospitals,problems in talent team construction,insufficient administrative talents,less than 40%,insufficient management ability,poor information system application,poor awareness of DIP,43.6%of DIP,and 42.3%;poor quality,clinical path and hierarchical diagnosis and treatment of homepage.3.SWOT analysis:advantages,perfect hardware facilities,leading level of information construction,disadvantages,inadequate performance appraisal mechanism,fine management of diseases,insufficient reserve of administrative talents,poor application ability of information system,and low willingness of clinicians to promote the payment of diseases and excellent implementation of DIP in some advanced areas,threats,patients,other medical institutions,regulators,etc.Policy suggestions:1.Medical institutions should strengthen the construction and training of hospital management talents and clinical business personnel;2.Increase the publicity of policies,improve the awareness and willingness of personnel to pay by disease score(DIP);3.Improve the fine level of comprehensive management of hospitals,including cost control,disease quality management,clinical path implementation,establish performance appraisal mechanism,information improvement and application,medical service level;4.Strengthen internal and external joint supervision of medical institutions.