Analysis of Medical Expenditure in Different Medical Institutions under Total Prepayment in Yinchuan

doi:10.7664/CHE20131210

Abstract：Objective: To analyze the effectiveness of total budget system on controlling the over-increasing medical expenditure, so as to promote the implementation of prepayment system and ensure the payment balance of medical insurance funds. Methods:Literature review and quantitative data collective method are used for description analysis methods. Results: There are no significant change of the average expenditure among the third and second grade hospitals. The second grade hospital decreased by 2.95% and the third grade hospital increased by 1.75%; but the overdrafts are significantly, that of the second grade hospital is 61.55% and that of the third grade hospital is 49.33%. Conclusion: At the beginning of total prepayment, the medical insurance centers and hospitals have not got enough thinking and comparative mature estimation scheme to face the problems of construction control under the total prepayment. Therefore, prepayment, overdraft and rejection of funds appeared which leads the insensitivity of controlling medical treatment cost. Suggestion: To design total payment system scientifically; to explore pay by desease and by unit based on total budget; to set up the medical service behavior evaluation system centered with the satisfaction of the insurers and the supple of peer reviews and to build incentive control mechanism of hospitals.