The Study About The Effect Of The New Policy On The Medical Expenses Of Public Hospitals In Zhejiang Province

BackgroundAlong with the development of the health service in Zhejiang province, some problems such as the ascending of the medical expenses and the medicine price comes forth and becomes the focus of the conflict between patients and hospitals. In order to control the rapid increasing of medical expenses and keep the development of the public hospitals, the two policies about "the management measure of improving centralized tendering process for drug purchase" and "standard and adjustment of medical service price" came into being in Zhejiang Province in 2004 and 2005. But after the execution of two new policies, the patients do not feel satisfied with the medical expenses, on the other hand, the economic operation become more difficult than before in public hospitals. This research wants to study on the effect of two policies on controlling the medical expense and the economical situation of the public hospitals by data statistic and experts visiting.MethodsThis research gives an analysis on the economic operation of 250 general public county hospitals and above in Zhejiang province before and after the two policies by making use of literature research, data statistic and experts visiting.Results 1. The effect of controlling the medical expenses:As a whole, the medicine expenses descended first, but rebounded after one year. The clinic fare per time, hospitalization expenditures and hospitalization expenditure per day ascended year after year. The burdens of patients did not lighten but aggravate.2. The change of the workload and work efficiency in public hospitals:The workload and work efficiency arose from 2003 to 2005, the number of serving outpatients and inpatients per employee also arose.3. The situation of the income composing in public hospitals:The proportion of the medical service income in operation income descended in 2004 but rebounded after one year, the medicine income changed the other way around. But there's no great change between the proportion of the medical service income and medicine income. The extent of adjustment on medical service price was very small, especially on the labor items, the value of working from the doctor and nurse did not get fair play. The adjustment of income structure was not prominent. The proportion of the medical service income in operation income descended and the hospitals operation still depended on the medicine income and examination income.4. The situation of the cost composing in public hospitals:The cost in public hospital arose year after year, especially the proportion of the medicine cost and medical material cost, and the cost of human resource ascended quickly.5. The balance of income and payout in public hospitals:The profit of medical service and medicine descended from 2003 to 2005 in public hospitals. The profit of medical service came to the bad year after year. The economical situation was imbalance between the medicine income and medical service income in public hospitals.ConclusionsThe execution of "two policies" has gotten the aim of reducing the medicine price and adjusting the price of some medical service items. But at the same time, ( the medical expense did not drop and the economy operation of )general public county hospitals depressed. There were two reasons for it: First, the financial investment to the public hospitals was too low. Second, the localization and unilateralism of the policies made the hospital depend on the expensive medicine and top grade examination to maintain the balance of income and payout, which also increased the burdens of patients.SuggestionsThe ultimate method to solve the problem of the high medical expense is to perfect the mechanism of the economical compensation in public hospitals. It is necessary to establish a reasonable proportion of financial investment for the public hospitals. Controlling but permitting the income from the medicine and setting down the standard medical service price based on the genuine cost. At the same time, it is also important to control the cost of the medicine and medical service by strengthening the accounting of hospitals and departments and by establishing the DRGs systems.