Study On The Effect Of The Cancellation Of Drug Addition And Medical Service Price Supporting Policies In Guangdong Province

In July 2017,public hospitals in various cities completely cancelled the drug bonus,and mainly compensated the hospital’s losses by adjusting the price of medical services in Guangdong Province.Up to now,the policy of abolishing medicines has been implemented in Guangdong Province for more than two years.The effects of reform are gradually emerging,and the price adjustment mechanism for medical services is becoming increasingly mature.Based on the actual reform situation,this paper analyzes the implementation effect of the cancelling drug addition policy and the supporting policy of medical services price adjustment from the two levels of the province and the prefecture-level city A.It also focuses on the price compensation of public hospital medical services,changes in hospital income structure,changes in patient burdens,and the overall performance of public hospitals in different regions or types.Finally,in view of the problems existing in the current price policy of medical services,reasonable suggestions are made to the government and hospitals.Literature research method,questionnaire survey method,field survey method,expert interview method,comparative analysis method,Theil index,principal component analysis method are used to research related issues.The results of the study show that:(1)From the perspective of the province,the average compensation rate for medical service prices in public hospitals after the cancellation of drug premiums was 85.21%,and the overall compensation situation was good,but some hospitals still suffered losses.In terms of patient burden,the effect of policy fee control is not obvious,and patient burden is still increasing year by year.The composition of hospital income has changed significantly,of which the proportion of medicines has decreased and theproportion of major technical labor services has increased.In terms of performance,regional differences affect policy performance,and the overall performance of public hospital policies of the same type shows significant differences in different regions.At the same time,different types of public hospitals will be affected differently by the same policy,and reform performance will be different.(2)The average price compensation rate of public hospitals in city A is 83.24%,and the price compensation effect is basically in line with expectations.After the reform,the average income of technical labor services in public hospitals increased by about 5%-7%,which shows a significant increase,further highlighting the labor value of medical staff.From the perspective of performance,TCM hospitals have the best performance overall,followed by maternity and child health hospitals,and finally comprehensive hospitals.In terms of patient costs,the average cost of inpatients in the city after the reform dropped by an average of 600 yuan in public hospitals.(3)A study of the county public hospitals in city A found that the local public hospitals had achieved price compensation but continued to suffer losses.In addition,local hospitals lack awareness of cost management,and internal hospitals lack control over unnecessary consumables and manpower expenditures.The local hospital lacks the development of technical labor services and lacks high-quality,sophisticated,or well-known specialty programs.Finally,the internal income structure of the hospital is unreasonable.Therefore,for the existing problems,it is suggested that the government should continue to strengthen the control of patient costs when formulating the next policy.When adjusting the price of medical services,different price adjustment policies can be formulated for different types of hospitals.The same price policy will be implemented for cities with similar economic and medical health levels to form a pricing mechanism for regional medical services.At the same time,the government needs to establish a dynamic price adjustment mechanism based on changes in cost and income structures as soon as possible.For public hospitals with severe losses,on the one hand,the government should increase its support,and on the other hand,it should encourage the development of new technologies and new projects.