Research on the effect of global budgeting in social health insurance towards the tertiary hospitals in Shanghai

Objectives:To evaluate the effect of the Global budgeting towards the tertiary hospitals and provide some suggestion.Methods:Data collection through qualitative interviews,questionnaire survey and database statistics,and statistical and theoretical methodology was used in data analysis.Results:The hospitals adjusted their strategies of development,communicated for more medical insurance amount,broadened the range of patients from other province and took various effective measures to control medical expenses of growth.Most clinicians felt the health services for the insured patients were affected.Statistics show that the medical expenses growth was under control and the structures of the insured patients’ drug fee were changed.There are also some different perceptions between insured patients and uninsured patients.Hospitals’ economic structure has changed and the patient self-payment proportion of health expenditure in hospital has risen.Conclusion:Global budgeting has positive effects and negative effects.In addition,the tertiary hospitals were also affected by other non-economic factors.Our policy recommendation is that exploring the regional Global budgeting of hospital Groups instead of each hospital,improving the Global budgeting model for more reasonable budgeting,encouraging tertiary hospitals to strengthen the management of healthcare expenditure.