Analysis of hospitalization and medicare payments of monopathy patients-A case study of a county in Shaanxi province

Objective To study the effect of monopathy payment through comparing the hospitalization and medicare payments of monopathy and non- monopathy in Shaanxi province, put forward policy recommendations targeting the existing problems in single disease payment, and provide a basis for the improvement of payment methods in China. Methods The participants in Shaanxi Province between 2007 and 2012 were enrolled into this study and assigned into monopathy group and non- monopathy group according to the monopathy payment (whether or not single disease). The number of inpatients, hospitalization expenses, hospital details and compensation costs were compared between the two groups. The Mann-Whitney U test was performed by SPSS statistical software. Results ①Between 2007 and 2012, the average hospitalization cost of monopathy was lower than that of non- monopathy, especially in 2011, the hospitalization cost of monopathy was 1 323 yuan, and non- monopathy was 3 467 yuan. ②The hospital days of monopathy was generally less than 7 days, however, non- monopathy was usually higher than 9.3 days. ③ Between 2007 and 2009, the ratio of monopathy patients accounted for more than 12%, but the proportion decreased to 8.89% in 2010, and further to 5% in 2011 and 2012. ④From the year 2011, the actual compensation ratio (50.45%) for monopathy was lower than that for non- monopathy (67.82%). Conclusion ①From the average hospitalization costs and hospital days, the effect of local NCMS single disease payment method is obvious. ②The reduction in the proportion of single disease patients prompted that the local monopathy payment model still needs some improvement. It is recommended to gradually expand the coverage of monopathy, the implementation of disease diagnosis related classification (DRGs). ③The proportion of monopathy payment that is higher than non- monopathy is not conducive to the promotion of single disease model. It is recommended that the local need to pay more attentions to the improvement of the actual compensation ratio of single disease, and explore the promotion of payment reform.