scholarly journals Assessment of Medical Service Pricing in China's Healthcare System: Challenges, Constraints, and Policy Recommendations

2021 ◽  
Vol 9 ◽  
Author(s):  
Wenying Xiong ◽  
Yufan Deng ◽  
Yili Yang ◽  
Yumeng Zhang ◽  
Jay Pan
Keyword(s):  
Healthcare System ◽  
Health Reform ◽  
Medical Service ◽  
Medical Services ◽  
Policy Recommendations ◽  
Constraint Factors ◽  
Medical Institutions ◽  
Service Pricing ◽  
Multiple Constraint

Medical service pricing reform was considered as one of the focuses of China's remarkable health reform. This paper preliminarily assessed the roles of medical service pricing in the context of China's healthcare system. Specifically, we described the potential roles of medical service pricing in China and pointed out relevant challenges that emerged in practice as the result of reform-related activities. Multiple constraint factors that might have induced undesired outcomes were then recognized, including the excessive diversity and specialization of medical services, the price inelasticity of patients' demand, and the inadequate capability of both medical institutions and administrations. Finally, we provided policy recommendations to inform the ongoing medical service pricing reform in China from a long-term perspective.

scholarly journals The Danish prehospital emergency healthcare system and research possibilities

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Tim Alex Lindskou ◽  
Søren Mikkelsen ◽  
Erika Frischknecht Christensen ◽  
Poul Anders Hansen ◽  
Gitte Jørgensen ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Record ◽  
Healthcare System ◽  
Emergency Care ◽  
Medical Service ◽  
Medical Services ◽  
Emergency Medical Service System ◽  
Emergency Medical ◽  
Medical Healthcare

Abstract The emergency medical healthcare system outside hospital varies greatly across the globe - even within the western world. Within the last ten years, the demand for emergency medical service systems has increased, and the Danish emergency medical service system has undergone major changes. Therefore, we aimed to provide an updated description of the current Danish prehospital medical healthcare system. Since 2007, Denmark has been divided into five regions each responsible for health services, including the prehospital services. Each region may contract their own ambulance service providers. The Danish emergency medical services in general include ambulances, rapid response vehicles, mobile emergency care units and helicopter emergency medical services. All calls to the national emergency number, 1-1-2, are answered by the police, or the Copenhagen fire brigade, and since 2011 forwarded to an Emergency Medical Coordination Centre when the call relates to medical issues. At the Emergency Medical Coordination Centre, healthcare personnel assess the situation guided by the Danish Index for Emergency Care and determine the level of urgency of the situation, while technical personnel dispatch the appropriate medical emergency vehicles. In Denmark, all healthcare services, including emergency medical services are publicly funded and free of charge. In addition to emergency calls, other medical services are available for less urgent health problems around the clock. Prehospital personnel have since 2015 utilized a nationwide electronic prehospital medical record. The use of this prehospital medical record combined with Denmark’s extensive registries, linkable by the unique civil registration number, enables new and unique possibilities to do high quality prehospital research, with complete patient follow-up.

scholarly journals A Game Model for Medical Service Pricing Based on the Diagnosis Related Groups

2021 ◽  
Vol 9 ◽  
Author(s):  
Jinli Duan ◽  
Zhibin Lin ◽  
Feng Jiao
Keyword(s):  
Social Welfare ◽  
Medical Service ◽  
Stackelberg Game ◽  
Diagnosis Related Groups ◽  
Equilibrium Price ◽  
Stackelberg Equilibrium ◽  
Game Model ◽  
Second Stage ◽  
Medical Institutions ◽  
Service Pricing

Background: Currently there are various issues that exist in the medical institutions in China as a result of the price-setting in DRGs, which include the fact that medical institutions tend to choose patients and that the payment standard for complex cases cannot reasonably compensate the cost.Objective: The main objective is to prevent adverse selection problems in the operations of a diagnosis-related groups (DRGs) system with the game pricing model for scientific and reasonable pricing.Methods: The study proposes an improved bargaining game model over three stages, with the government and patients forming an alliance. The first stage assumes the alliance is the price maker in the Stackelberg game to maximize social welfare. Medical institutions are a price taker and decide the level of quality of medical service to maximize their revenue. A Stackelberg equilibrium solution is obtained. The second stage assumes medical institutions dominate the Stackelberg game and set an optimal service quality for maximizing their revenues. The alliance as the price taker decides the price to maximize the social welfare. Another Stackelberg equilibrium solution is achieved. The final stage establishes a Rubinstein bargaining game model to combine the Stackelberg equilibrium solutions in the first and second stage. A new equilibrium between the alliance and medical institutions is established.Results: The results show that if the price elasticity of demand increases, the ratio of cost compensation on medical institutions will increase, and the equilibrium price will increase. The equilibrium price is associated with the coefficient of patients' quality preference. The absolute risk aversion coefficient of patients affects government compensation and total social welfare.Conclusion: In a DRGs system, considering the demand elasticity and the quality preference of patients, medical service pricing can prevent an adverse selection problem. In the future, we plan to generalize these models to DRGs pricing systems with the effects of competition of medical institutions. In addition, we suggest considering the differential compensation for general hospitals and community hospitals in a DRGs system, in order to promote the goal of hierarchical diagnosis and treatment.

scholarly journals Medical service as a part of everyday life of workers of the ferrous metallurgy enterprises in the first half of 1950s.

2018 ◽  
Vol 21 (9) ◽  
pp. 98-104
Author(s):  
A. M. Melnyk
Keyword(s):  
Medical Care ◽  
Ferrous Metallurgy ◽  
Medical Service ◽  
Medical Services ◽  
Medical Unit ◽  
Medical Aid ◽  
Medical Institutions ◽  
The 1950S ◽  
Medical Examinations

The aim of the study is to analyze medical aid given to the workers of ferrous metallurgy enterprises in the first half of the 1950s. Primary medical unit provided medical aid for workers of the ferrous metallurgical enterprises. Because of the lack of medical unit at the metallurgical plant or because there was no medical institutions in the organizational structure of the medical unit, local medical institutions provided the workers with medical care. During the first half of the 1950s, was the problem of the lack of medical staff in the medical institutions caused by insufficient material and household support. It did not allow implementing the shop principle of medical service of metallurgists. At the enterprises, individual shops did not have a factory’s sectorial doctor, or the number of workers assigned to a factory’s sectorial doctor exceeded the norm. Because the local hospitals, which controlled the health post at the ferrous metallurgy enterprises of the Zaporizhzhya region, were placed at a considerable distance, ‘the shop principle’ was not implemented there at all. The personnel problem also affected the formation of queues, which were a characteristic feature of the medical care provided to the workers. Work overload of physicians led to a quick examination of the patients, resulting in mistakes in the diagnosis. Contrary to accepted laws aimed at improving the quality of diagnosis, the periodic medical examinations of workers were not always carried out qualitatively, and the medical examination was carried out in a number of plants partly. In the first half of the 1950s the enterprises of the ferrous metallurgy of Zaporizhzhya region had a problem that the medical institutions were on a far distance and the percentage of patients needed medical help reduced. Lack of hospital beds had caused the untimely hospitalization of patients that prevented recovery of their. Many of the medical institutions were located in the old or non-specialized buildings with limited space, stove heating and primitive food units, without household premises and sewage. Characteristic of the medical services of metallurgists were depreciation of the material fund of medical institutions, lack of medicines, medical equipment. Not all medical institutions were provided with ambulances. There were cases of refusal to leave for a challenge or untimely provision of emergency care. It was concluded that the level of medical services given to the metallurgists in the first half of the 1950s was insufficient, despite the fact that they were workers of one of the leading branches of the Soviet economy.

scholarly journals Social Network Analysis of Integrated Medical Services for Hypertension – Using District Hospitals of Shanghai as a Model

2020 ◽  
Vol 3 (1) ◽  
pp. 1-13
Author(s):  
Ziyou Chen ◽  
Junshan Li ◽  
Fen Li ◽  
Yuanan Lu
Keyword(s):  
Social Network ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Medical Service ◽  
Service Providers ◽  
Medical Services ◽  
Main Role ◽  
Medical Institutions ◽  
District Hospitals ◽  
Degree Of Association

Objective To examine the current linkage between different medical services for hypertension patients for enhanced integration among medical service systems. Methods A total of 18 hospitals and community medical centers from a district of Shanghai were enrolled for social network analysis which covered emergency visits and hospitalization records of 171,177 outpatients with hypertension. Stata software was used for data preprocessing and UCINET software was used for network analysis of medical service providers to quantify and visualize the network tightness and the "main role" of information delivery of the medical institution network in the area. Results The service network of hypertension consultation institutions in the region is closely connected as a whole, but the level of diagnosis and treatment of medical services in various communities varies widely, and the degree of association with higher-level medical institutions is not uniform. Conclusion Based on the limited tightness of various medical service providers, it is necessary to implement the responsibilities of individual medical institutions at different levels and pay more attention to improving the service capabilities of primary medical institutions for enhanced integrating medical services in future.

The investigation and analysis of the current situation of medical service price cognition of China with grey relational analysis theory

2019 ◽  
Vol 9 (2) ◽  
pp. 164-174
Author(s):  
Lili Yin ◽  
Lizhong Duan ◽  
Yinran Zhang ◽  
Hangyu Liu ◽  
Chongxu Zhang ◽  
...  
Keyword(s):  
Grey Relational Analysis ◽  
Questionnaire Survey ◽  
Medical Service ◽  
Medical Services ◽  
Dynamic Adjustment ◽  
Hospital Workers ◽  
Content Type ◽  
Relational Analysis ◽  
Medical Institutions ◽  
Grey Relational

Purpose Through a questionnaire survey, the purpose of this paper is to understand and analyse the cognitions of medical service price of medical workers in various regions of China, and discuss the policy suggestions on the price dynamic adjustment of medical service. Design/methodology/approach The authors conducted a questionnaire survey on the cognition of medical service price medical workers in various regions of China, and then the grey relational analysis theory is used to analyse the data obtained from the questionnaire survey. Findings The investigation and analysis shows some cognitions of hospital workers on the price of medical services in various regions in China, the authors analyse the results of grey relational analysis and come up with suggestions for relevant departments. Research limitations/implications Although a plenty of research on the current situation of medical service price cognition of China is discussed in the paper, it is not complete; thus, a large amount of information needs to be consulted further. The data obtained from the questionnaire are less used and the utilisation rate is lower, which may result in one-sided results and need further investigation. Practical implications Through the investigation and analysis, the authors can determine about the implementation of medical service prices in various parts of China from the perspective of hospital workers to a certain degree, and try to explore the relevant policy recommendations for the dynamic adjustment of medical service prices. Social implications The price of medical services refers to the fees for registration, diagnosis, inspection, surgery, nursing and medicine. In a narrow sense, the price of medical services refers to the standard of charge for medical services except drugs. This paper mainly refers to the narrow sense. As one of the important means and methods for the government to control the medical service market, medical service price is also an important basis for the economic source of medical institutions. The adjustment of medical service price is related to the interests of all aspects of society. Originality/value Medical service price is an important basis for the economic source of medical institutions, the adjustment of medical service price is related to the interests of all aspects of society and it is a hot issue of social concern. Through the investigation and analysis, the authors use grey relational analysis to know about the medical service prices in various parts of China from the perspective of hospital workers to a certain degree, and try to explore the relevant policy recommendations for the dynamic adjustment of medical service prices.

PROSPECTS FOR THE DEVELOPMENT OF MEDICAL INSTITUTIONS UNDER THE CONDITIONS OF HEALTH REFORM

2019 ◽  
Vol 15 (69) ◽  
pp. 018
Author(s):  
A. H. Vasilyev ◽  
V. M. Mykhalchuk ◽  
Z. V. Hbur ◽  
Yu. V. Voronenko
Keyword(s):  
Health Reform ◽  
Medical Institutions

Gaining access to the field in medical ethnography: Reflections on ethical, methodological, and structural challenges in the study of long-term care facilities

2021 ◽  
pp. 136345932098887
Author(s):  
Neta Roitenberg
Keyword(s):  
Long Term Care ◽  
Ethnographic Research ◽  
Term Care ◽  
Medical Institutions ◽  
Care Workers ◽  
Care Facilities ◽  
Key Issues ◽  
Access To The Field ◽  
Medical Ethnography

The article extends the discussion on the challenges in gaining access to the field in medical ethnographic research, focusing on long-term care (LTC) facilities. Medical institutions have been documented to be difficult sites to access. The reference, however, is to the recruitment of patients as informants. The challenges of recruiting practitioners as informants have not been investigated at all. The article presents the key issues that emerged in the process of gaining social access at the sites of two LTC facilities as part of a study on care workers’ identities. The main obstacles encountered during the fieldwork were organizational constraints and negotiating control over the process of recruiting the lower occupational tier of care workers with gatekeepers. The article presents the coping strategies implemented to overcome the ethical and methodological obstacles: continually reassessing the consent and cooperation of participants and developing a rapport with nurse’s aides during interviews.

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