供方支付方式改革对核心利益相关主体行为影响的研究-社会医学与卫生事业管理专业论文.docx

第三军医大学博士学位论文 第三军医大学博士学位论文 万方数据 万方数据 The Impact of Reforming Provider Payment of Medical Insurance of Chongqing to the Core Stakeholders’ Behavior Abstract Medical expenses are too high or rising too fast is a common phenomenon in today s world , health system reform has become the key topics and problems . With the full implementation of medical insurance ,it slows down “sees a doctor difficulty,to see a doctor expensively”. The medical needs of the people becoming more and more.At the same time, Health care providers (hospitals, physicians , etc.) profit space has been further expanded.But the supply-side focus only on the volume and intensity of medical services in fee-for services. International experience has fully proved :fee-for- services is one of the main reasons that lead to medical costs rising rapidly . Therefore, reforming provider payment is the main tasks of complete the basic health safeguard system. Provider and demand-side both are the core Stakeholders. Medical treatment decisions will directly affect the efficiency of the two medical resources : quantity and quality , and then further affect the cost and efficacy of the entire health care system . Demand-side response is very important because they are the recipients and direct beneficiaries, and directly impacts on the system lasting and stable development . people usually revolve around the quality and cost of medical services when they analyze the pros and cons of different payments .payments have an impact on the medical practices of the Stakeholders , cost control , resource allocation , and the quality of medical care and health services , efficiency , equity oriented or restraining effect .Researchs Increasingly concern about behavior of providers and demand-sides. Reforming provider payment of medical insurance started relatively late,and needs to continue to promote and improve. its depends on the stakeholders balance of interests or a reasonable the external environment if a paymen