** Control fees determine the direction of medical information

The model of a country’s medical insurance control fee is mainly determined by the country’s medical expenditure structure, and the medical expenditure structure determined by the country is the medical system implemented by the country and the participants’ medical services and drug prices established on this basis. Leading power. Studying the model of medical insurance control fee under different medical systems in different countries has important reference significance for guiding the development direction of future medical insurance control fees in China.

Under different medical systems, the structure of medical expenses is different, reflected in the different market positions of participating parties in the medical market. At present, there are four types of medical insurance models recognized in the world: the universal medical model, represented by the United Kingdom, with government expenditures leading the expenditures on medical expenses; the social insurance model represented by Germany, and the socialized third party leading the expenditure on medical expenses. The market-led model, represented by the United States, dominates the expenditures of insurance companies that control and control; the savings fund model, represented by Singapore, accounts for relatively high personal expenses, and hospitals dominate the medical service market.

Different medical expenses structure determines the way of medical insurance control fees. The party with a high proportion of medical expenses is generally dominant in the medical system, and has strong control over the prices of medical services and drug prices. For example, the government accounted for 82% of medical expenditures in the United Kingdom and dominated the medical system. In the health care expenditure of Germany, the Socialization Foundation accounted for 76%, which effectively controlled the medical service market; the medical medical insurance in U.S. medical expenditure occupied Importantly, the controlled and controlled medical insurance model dominates; Singapore’s personal payment accounts for a relatively high proportion, reflecting the fact that public hospitals have dominated Singapore’s healthcare system.

China's medical system is still not perfect, and hospitals, medical insurance centers, and commercial insurance are mutually difficult to change in the field of medical insurance control fees in the short term, and there is a long way to go for medical insurance control fees. With the deepening of medical reform in China, the proportion of government and insurance companies in medical expenses has gradually increased. However, at present, China’s personal payment still occupies a considerable proportion. It is reflected in the current medical system that the hospital’s clinical path and prescription rights are highly developed. To a certain extent, it affects the effect of medical insurance control fees. With the gradual strengthening of China's medical insurance control fee, and around the dominance of medical insurance control fees, the game between the parties will be more intense. We recommend to pay attention to companies related to the field of medical insurance and control fees, including: Weining Software, Haihong Holdings, Neusoft shares and Wanda information. The text is over. You can press alt+4 to comment

The payment share determines the dominance of the medical insurance control fee, and the dominance of the medical insurance control fee determines the direction of medical informationization. In the past, the proportion of individuals paying for medical expenses was relatively high, and hospitals had a greater impact on medical expenses. Medical informatization was aimed at improving the hospital's revenue, and hospital-based HIS was the informatization. With the increase in the proportion of China's medical insurance expenditure, the focus of information construction will be on the purpose of data exchange, and informationization based on regional medical and medical insurance control fees. This part will be the focus of future investment.

From the perspective of foreign countries: It is fully proved that the leading power of medical insurance control costs determines the path and type of information. U.S. commercial medical insurance led medical expenditure, which determines the medical information system with the focus on data interaction in the U.S. and the purpose of monitoring drug costs and medical service costs; the European government or foundation led the medical expenditures and determined European medical care. Informatization focuses on data standardization to facilitate the analysis of management-oriented medical informatization systems; Singapore is a hospital-led medical system, which forms a medical information centered on the optimization of processes, with cost reduction and efficiency enhancement, and customer satisfaction improvement. System.

From the domestic situation, the underlying data of medical information has been relatively complete, and the information-based space with data exchange as its focus is vast. With the increase in the penetration rate of hospital HIS and the information construction of the “Golden Insurance Project” system, the underlying data construction is basically in place and the market space is small. However, the information-based construction focusing on data exchange is in its infancy and is the focus of investment in the future.

The medical information monitoring system based on data interaction will be gradually established. The monitoring system is mainly divided into the monitoring of drugs and the monitoring of medical services: The core element of drug monitoring is a powerful medical database; the core element of medical service monitoring is data collection on a wide area. For listed companies: Haihong Holding has a strong medical database. Weining Software, Neusoft Corporation, and Wanda Information have a wide range of data collection capabilities. These companies are in a favorable position for the development of the industry, and they recommend long-term attention.