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    Home > Active Ingredient News > Drugs Articles > 3 dimensions, explore the framework of medical security development index system

    3 dimensions, explore the framework of medical security development index system

    • Last Update: 2020-11-27
    • Source: Internet
    • Author: User
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    With China's per capita GDP standing at a new level of 10,000 U.S. dollars, national health consumption demand and national health care system construction goals are about to take place a series of new changes, the national health care policy and management services should also enter a high-quality and efficient development stage.
    In order to better solve the problem of unbalanced development in the field of medical security and continuously improve the medical security system, the Opinions of the State Council of the CPC Central Committee on Deepening the Reform of the Medical Security System (hereinafter referred to as the Opinions) issued in February this year outlined the strategy for the reform and development of China's medical security system with "five adherences" in the basic principles section, and put forward the development goals of the 2025 system and the improvement of the 2030 system.
    Opinions put forward the need to fully implement the budget performance management of the medical insurance fund and establish the performance evaluation system of the medical insurance fund.
    performance management means that under the established development strategy, through the management object of the whole process, full staff, all elements of the benchmark, indicator management, to ensure the full realization of development goals.
    as a modern management model, performance management has the greatest advantage over traditional annual settlement system management: it can ensure the consistency of strategy, objectives, processes and results.
    Based on the "Five Persistences" put forward in the Opinion, the author, drawing on international experience and global consensus, suggests that the construction of China's medical security development index system should be explored from the three dimensions of "reasonable financing, policy science and effective governance" (or first-level indicators);
    , the rationality of financing In this dimension, three secondary indicators should be set up: "to collect funds", "reasonable sharing" and "health output".
    , the level of financing is determined according to the level of economic development and population structure, including the total cost of health, the proportion of health insurance funds to GDP, etc.
    Second, the government, society and individuals should reasonably share the cost of medical care, of which medical insurance as a social mutual assistance fund should account for more than 40%, the government budget accounted for about 30%, the individual self-funded part accounted for 20%;
    In 2018, China's medical cost-sharing ratio is 27.74 percent of the government, 43.66 percent of social insurance, 28.61 percent of individual self-funding, the future improvement space is to vigorously develop commercial health insurance to reduce the proportion of personal self-funding.
    third is national health output, i.e. the average life expectancy and healthy life expectancy of the population in the context of a certain total health cost input.
    , policy science Policy science should include performance evaluation of the six secondary indicators of "coverage", "poverty rate", "rate", "payment range", "share rate" and "fund operation".
    Coverage includes basic medical insurance coverage for employees and residents; poverty rate includes uninsured due to poverty and catastrophic expenditure; rates include wage base, contribution base and rate; payment range includes diseases, medicines, medical materials and equipment;
    3. Governance Effectiveness The dimension of governance effectiveness should consist of seven secondary indicators: "cost growth", "payment method", "agreement management", "fund supervision", "health care system", "health insurance service", "third-party evaluation" and "social satisfaction".
    increases in health-care costs include increases in expenditure on health funds and increases in total medical costs;
    payment method indicators should be divided into quantity, quality and value payments by category, in order to examine the guiding role of health insurance payment methods.
    agreement management includes medical insurance and inter-hospital information sharing, equal consultation, agreement management information platform, agreement implementation.
    supervision mechanism is divided into pre-guidance, in-process control, after-the-fact feedback.
    The health care system includes the distribution of health care resources between inpatient, outpatient and community care, the distribution between medical treatment, rehabilitation, nursing and end-of-life care, and the cost distribution of medical care, medical services include accessibility and convenient mobility of services under the unified system, as well as head and cost ratios of operating institutions, and third-party assessment and social satisfaction, including evaluation and satisfaction of academic institutions, social organizations and public opinion.
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