A Case Study On The Influence Of Zero-profit Drug Policy Of Community Health Care Institutions In Shanghai

Purpose: Zero-profit Drug Policy was one of the important paths to address the issue of high drug prices artificially,solve the problem of expensive health care and ease the economic burden of disease.The Community Health Care Institutions in Shanghai fully and formally implemented Zero-profit Drug Policy in 2011.6.The Community Health Care Institutions were not able to get profits by drug sales as Zero-profit Drug Policy,which had a significant impact on the economic operation,balance of payment,services supply and drug use behavior,and also impacted the doctors and community residents.This research was a case study on a large community health service center in Shanghai,analyzed the changes economic operation and drug use behavior from 2011 to 2014,fully understood the policies associated changes before and after,clarified the continuous impact of various interest groups,analyzed the causes of changes and put forward corresponding suggestions.Methods: Through the analysis of the Policy documents to determine the key interest groups of Zero-profit Drug Policy;through literature analysis and expert consultation to understand the implementation progress and effect assessment of the policy;through the data of medical expenses,medical service quantity and balance of payments to analyze the influence of the policy to the institution;through the questionnaire survey to analyze the influence of the policy to the medical staff community residents.Outcome:(1)The proportion of drug income declined,but the effect to control the medical expense was not obvious.(2)Excessive medical behavior still exist and the average drugs amount per prescription was still high after the implementation of the policy.(3)The leading position of drugs for chronic diseases has become increasingly clear in the community.(4)Antibiotics and infusion drugs utilization rate declined year by year.(5)Medical income was still the main source of the community health service institution and the balance of payments was in good condition.(6)The cognition degree about the policy was not high and the low proportion of staff training was a problem.Suggestions:(1)Build the reasonable drug pricing mechanism,and prevent artificially high drug prices.(2)Form a stable long-term financial compensation mechanism and cut off the income of the medical institutions and medical personnel with drug income.(3)The selection of zero-profit should give attention price,quality and the need of the residents,and enhance the confidence of both the doctors and the community residents.(4)Strengthen the supervision of drugs and standardize prescription to regulate the rational use of drugs.(5)Propaganda the policy and strengthen staff training to ensure the smooth implementation of the policy.