It is advanced to settle the whole country of the method the expenses of medical insurance of Huaian of Jiangsu

It is advanced to settle the whole country of the method the expenses of medical insurance of Huaian of Jiangsu
It is advanced to settle the whole country of the method the expenses of medical insurance of Huaian of Jiangsu
Author: It is a world difficult problem that Li banks up beautiful medical insurance with earth, it is difficult in the expenses are difficult to settle. However, the medical insurance of the city is 6 years with great concentration of centre, study the advanced and ripe experience of management abroad, find out " Press the dividing value of number and calculate the method " ,Impelled the fixed hospital to reduce the hospitalization cost, effected an insurance personnel have enjoyed the basic medical treatmented, the medical insurance fund has realized steady operation. So-called " press the dividing value of number and calculate the method " ,It is according to different Shi Zhi's requirement and historical average level of the expenses, give different scores of each number determination. Serious disease and serious illness " The score " High, the small disease, light disease " score " Low, different hospital of grade, score multiply by different coefficient, in order to add up to the total score and medical insurance centre to check out every month such as hospital. Money soldier, director of centre calls that the medical insurance of the city vividly " Fix work point " ,The hospital lets " Earn work point " . Launch DRGs management system to manage the medical insurance fund, mean that extending the medical insurance tradition settlement way for several years changes. The medical insurance centre of the city is along " strengthens the total amount and desalinizes the quota " Thinking,it is fixed without being let medical organization limit by norm while a patient cured the disease to give and effect an insurance, have put emphasis on constructing and curing due to illness. "Number ' the score ' in this method has actually given clinicians a standard, for example appendicitis, appendicitis at various degrees has different scores, then the doctor will be chosen a best healing solution more favorable to the patient while treating, using medicine, but not construct and manage blindly. Say from certain meaning, ' press the dividing value of number and calculate the method ' have become an effective way which solves the masses ' see the doctor expensively ' too in fact. " Medical insurance Hu Di, section chief of department of the People's Hospital says frankly second in city. Mention that studied 6 years ago " Press the dividing value of number and calculate the method " ,The money army says that is forced out. Because the intersection of the whole city and medical fee rise surprising at that time, per person Figo occupied the leading place in the whole province in hospital. They realize, can't be by " rule by men " only ,It could make the fixed medical organization construct and cure, charge rationally due to illness to depend on the management with effective science. Through surveying and studying, analyzing, comparing, proving, the money army has put forward DRGs scheme in line with international standards boldly, " calculate the method according to the dividing value of number " . In October of 2003, " pressed the dividing value of number and calculated the method " After implementing, make the per capita hospitalization cost drop by 1800 yuan in the first quarter alone. " press the dividing value of number and calculate the method " Pursue 6 year in Huaian, make, effect an insurance person enjoyed the basic medical treatment not merely, the fixed hospital has reduced the hospitalization cost, also realized the steady operation of the medical insurance fund at the same time. This kind of medical insurance suffered from the situation that the three sides won together to arouse the attention from the whole province and even national medical insurance trade experts and scholars. Entrusted by medical insurance research association in the province the Huaihe River right " Press the dividing value of number and calculate the method " Southeast China University Professor carrying on investigation of special topic opens gold and makes the metaphor of a image: "It is a sink that the medical insurance fund can be compared to, every fen can have a faucet to control, the switch on the tap is a settlement way. ' press the dividing value of number and calculate the method ' in line with international standards, put ' the faucet ' of the fund of medical insurance of Huaian in scientific management, this is very advanced too in the whole country. "


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