Not long ago, Li Xu, a villager from Gaoshawo Town, Yanchi County, Ningxia Hui Autonomous Region, suffered from appendicitis and was admitted to the County People's Hospital for treatment. From hospitalization to discharge, the expenses were reimbursed 80%. In the end, he only paid 520 yuan. In Yanchi County, cheaper patients are attracting more and more patients to stay in the county for treatment. Ma Ruiying, deputy magistrate of Yanchi County, said that this benefited from the county's reform of the innovation payment system in 2010.
“In the past, patients in Yanchi had gone to large hospitals in Yinchuan and Wuzhong, and the phenomenon of minor illnesses was widespread.†Ma Ruiying said that the county explored the implementation of outpatient fees and county hospitals in the primary health care institutions. The prepayment system uses economic levers to incite patients to make rational use of primary health care resources, graded diagnosis and treatment, effectively reduce medical costs, and improve the use efficiency of medical insurance funds.
In the past, the drawbacks of paying for medical insurance system projects were “medical supplementation†and “insufficient drug price checkâ€. It is common for medical staff to issue various unnecessary tests and drugs to patients, resulting in a rapid increase in medical expenses. The innovation of the package intervention payment is that the post-payment system becomes the pre-payment system, and the project payment becomes the package payment.
“In the past few years, the hospital has maintained balance of payments and paid more attention to public welfare, focusing on improving service capabilities and controlling and reducing medical costs.†Wei Yongjun, deputy director of Yanchi County People’s Hospital, said that in 2016, Yanchi County People’s Hospital The funding for the package is 2,194,470 yuan. The hospital has strictly managed the average cost of hospitalization, the average length of hospital stay, the number of hospitalizations, the proportion of drugs, the intensity of antibiotic use, the referral and high-value consumables, and the use of auxiliary drugs. The average cost of hospitalization is 3173.7. Yuan, significantly lower than the regional average, the proportion of medicine dropped from 50% in 2012 to 33.8% in 2016.
Nowadays, the dilemma of replenishing medicines has gradually been broken. Under the intervention of the package, hospitals, patients and medical insurance have achieved “three winsâ€: the hospital has won good reputation and mass satisfaction, and the patients have achieved the goal of spending less money to see the disease. The county's medical insurance fund has a cumulative balance of 91.13 million yuan, and the risk of use has been significantly reduced.
According to statistics, the number of outpatient visits at the township and village levels in Yanchi County increased from 53,000 in 2009 to 300,000 in 2016, an increase of 466%. The outpatients flowed to the rural two-level medical institutions, and the treatment mode of minor illnesses in the rural areas and in the outpatient clinics gradually formed, and the burden of medical treatment for farmers was greatly reduced. The growth rate of hospitalizations outside the county has dropped from 34% in 2012 to 27.8% in 2016. The number of hospitalizations in county-level hospitals increased from 6590 in 2012 to 12,637 in 2016, and 83% of patients remained in Yanchi County for treatment. At present, Yanchi County has basically achieved the goal of grading diagnosis and treatment of "small illnesses do not leave the village, common diseases do not leave the country, major illnesses in the county, and intractable diseases go out of the county".
On the basis of the innovative payment system, this year, Yanchi County has established an “eight projects†for health and poverty alleviation, building a more solid safety net for poor households. The insurance premium for major illnesses has been raised from 45 yuan in the autonomous region to 90 yuan, and the reimbursement rate has increased from 60% last year to over 80%. The maximum reimbursement limit has been raised from 80,000 yuan last year to 200,000 yuan. The deductible line was last year. 9300 yuan was reduced to 3,000 yuan, hospitalization expenses outside the medical insurance catalogue were reimbursed by 70%, and the maximum reimbursable amount was 20,000 yuan. The poverty-stricken households in the poverty-stricken households were able to enjoy the policy of rural low-income households. The maximum rescue rate was increased from 80,000 yuan to 160,000 yuan. yuan.
In May of this year, Zhang Huifeng, a poor household in Haojitai Village, Qingshan Township, Yanchi County, suffered from drug-induced liver damage caused by toxic epidermal loosening, and hospitalization costed more than 180,000 yuan. In accordance with relevant policy standards, the basic medical insurance reimbursement is 65,182 yuan, the major illness insurance reimbursement is 38,171 yuan, and the major illness supplementary insurance is reimbursed 24,938 yuan. In addition, Zhang Huifeng also received a 4,000 yuan bailout from Qingshan Township. The Yanchi Health Development Foundation rescued 8513 yuan and reimbursed a total of 140,000 yuan, greatly reducing the financial burden of a family.
“At present, the electronic filing rate of the health records of the poor population in Yanchi County is 94.5%, the rate of visiting patients in poverty-stricken areas is 94.5%, and the number of poor patients is more than 5,000. The high standard has passed the acceptance of the National Health Promotion County.†Ma Ruiying Say.
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