Study On The Relationship Between The Proportion Of Drug Cost In Total Medical Expense And Medical Cost Control And On Relevant Control Policies

Based on the reality that the irrational growth of medical expenditure is always existing for a long time in our country,In June 2015,the General Office of the State Council issued Guiding Opinions on the Pilot Project of Comprehensive Reform in Urban Public Hospitals,which urged urban public hospitals in pilot cities to reduce the proportion of drug(excluding Traditional Chinese Medicine)in total medical expenditure to 30%or less by 2017.This policy is intended to improve the rational use of clinical drugs,avoid the growth of irrational medical expenses,and to lighten the economic burden of the Chinese patients.In 2012,The Zhejiang Health Commission started carrying out the "Sunshine Drug Project",which requires county-level hospitals make statistics of at least nine indicators and publish it to the society,which includes the proportion of drug expenses in total medical expenditure,average medical expenses and drug expenses per capita for outpatients and for inpatients,etc.The indicators were required to be released quarterly in accordance with the regulated format.This essay takes Zhejiang province as an example to study the changes of the average medical expenses and drug expenses,the proportion of drug cost in total medical expenditure before and after the implementation of the policy of Controlling the Proportion of Drug Cost in Total Medical Expenses.It also performs a classic difference-in-differences analysis which could evaluate the effects of this policy to analyze whether controlling the proportion of drug cost in total medical expenses has achieved the goal of controlling medical expenses.Based on the results,we could learn about the function of this policy and relationship between drug proportion in total medical expenses and medical expenses control so as to provide suggestions for government with drawing on the experience of other areas simultaneously.Firstly,analyzing the factors which could affect the drug proportion in total medical expenses and the basic means of realizing management and control based on ensuring the definition of the drug proportion in total medical expenses with the angles of connotation and calculation.After knowing the government public purposes of medical expenditure controlling,setting up the theoretical model of the drug proportion in total medical expenses and medical expenditure controlling to study their interaction,the effect of the drug proportion in total medical expenses on theoretical level.Secondly,comparing the drug expenses and total medical expenditure before and after the implementation of the policy.On the premise,structuring a difference-in-differences analysis model to assess the real effect of this policy.The results shows that controlling the proportion of drug cost in total medical expenses couldn't reduce the medical expenditure.Besides this,the reduction of the proportion may result from the other increase except drug by taking the structural change analysis method.So as a relative indicatrix,the proportion of drug cost in total medical expenses has limited influence on medical expenditure without other precise measures.Thirdly,drawing on the experience of America and Canada by introducing their experience and measures in controlling medical expenditure.And then summarizing the characteristics of practice of the two countries.Based on these,providing the appropriate suggestions for our countries:reforming the medical service price,taking advantages of modes of payment in health insurance system,splitting medicine and medical service authentically.At last,collecting and classifying the essays relating the medical expenditure controlling in order to establish the policy and strategy toolkit for medical cost control.At the same time,giving the suggestions and measures with four parties including government,medical insurance department,medical institutions,patients and pharmaceutical companies.