Preliminary Assessment Of Comprehensive Reform Of County Public Hospital In Zhejiang Province

Backgrounds and ObjectivesThe reform of public hospitals is one of the key tasks of the new medical reform. In Zhejiang province, all of the public hospitals at the county level (291hospitals) had launched the reform. This study focused on the comparative analysis and discussion of comprehensive reform of public hospitals at county level in Zhejiang Province from horizontal and vertical aspects. It aimed at evaluating the performance changes of comprehensive reform of county-level public hospitals. The problems existed in this reform were necessary for perfecting the policies and keeping the sustainability of the reform.Materials and MethodsThis study was divided into two parts:The first one was the intervention study on the comparison of public hospitals at county level in Zhejiang Province from horizontal aspect. There were8hospitals which launched the reform in December,2011. It was the intervention group.131hospitals which launched the reform in December,2012were used as a control group. The performance indexes from January to June in2011and from January to June in2012in each group were analyzed.The second one was the intervention long-term study on the comparison of public hospitals at county level in Zhejiang Province from vertical aspect. The objects of the study were also the8hospitals which launched the reform in December,2011. The performance indexes from January to June in2011-2013were analyzed.The normal distribution test, homogeneity of variance test and Mann-Whitney U test and descriptive statistics including the calculation of the mean and the year-on-year growth rate were used to analyze the performance changes before and after the reform.ResultsAfter the reform, the outpatient drug revenue, outpatient western drug revenue, outpatient medical service revenue, inpatient drug revenue, inpatient western drug revenue, inpatient traditional Chinese drug revenue and inpatient medical serveice revenue were significantly increased. The proportion of outpatient drug revenue and inpatient drug revenue were decreased significantly. Moreover, the reform decreased significantly the average outpatient drug fees, average outpatient western drug revenue, average inpatient drug revenue and average inpatient western drug revenue. The average outpatient medical service revenue and average inpatient medical service revenue significantly increased. The quantity of western drug did not decrease. The long-term effects had no significant differences in the reform.ConclusionThe zero profit drug supply policy and the medical service price adjustment policy in the reform of county-level public hospital had implementation effect. But the results also exposed the shortcomings:the hospital was still chasing profits and doctors had not changed their medical behavior. It needs a further study of the reform.