Analysis of inpatient payments of breast cancer patients with different medical insurance coverages in China(mainland) in 2011–2015

Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.

Study on the difference of payment time of medical insurance in China

Since medical insurance of our country developed, it is continued to deepen reform and became the basic form of the pcrfcct medical insurance system. However, regional differences still exist. The current medical insurance system of China＇s urban and rural structure background of two structures of serious, city residents, workers and rural residents is significantly difference in the payment period ,for this question ,the difference between our country will solve the basic medical insurance payment period, the relative level of regulating wages and medical people in our country and develop the medical insurance level, narrow the regional differences, reduce cost problem caused by population flow management, the basic medical insurance system for suggestions to improve the unified and promoting the social and economic level, people＇s medical security level, perfect improvement of physical insurance system of medical insurance according to the long-term sustainable development has a far-reaching significance.

“十四五”时期我国卫生健康事业发展展望

“十四五”时期,我国卫生健康事业步入新的历史阶段。在这一时期,公共卫生能力建设应成为发展重点,通过优化医疗卫生资源配置,实现大健康观下的医防结合。推动以医疗为中心的医疗联合体转变为以预防和健康管理为中心的健康联合体,使医疗保险为公众的健康结果而非医疗卫生服务买单。完善健康服务体系,实现健康联合体内部上下联动。建立以健康结果为导向的医疗保险支付方式,倒逼服务供给侧改革,推动医疗保险基金形成战略性购买机制。充分发挥信息时代互联互通的优势,深化健康大数据的治理与应用,助力公众健康管理。

美国医用耗材采购管理模式及对我国的启示

目的介绍美国医用耗材采购管理模式的改革过程,为我国医用耗材的采购及医疗保险支付管理提供参考与借鉴。方法采用文献分析法,从采购组织、采购模式、医疗保险支付标准制定等方面总结分析美国医用耗材采购管理的成功经验。结果美国通过与医用耗材编码系统相结合、引入市场竞争的方式完善采购模式,成功降低了医用耗材的价格。结论统一的医用耗材分类标准是耗材采购模式的核心,应充分结合利用医疗保险医用耗材分类与代码数据库开展医用耗材的带量采购。