Status Evalutaiton Of Country-level Public Hospitals’ Financial Subsidy And The Impact On Service Amount And Fee

ObjectivesTo Evalutaiton the current status of public hospital operating financial subsidies at the county level, analysis the impact of operating subsidies on hospital services and service fees, finally provide empirical evidence and some suggestions for public hospital operating subsidy policy.Contents1. Literature Review and theoretical basis for the operating financial subsidy.2. The current situation of public hospital financial aid status, the operating financial subsidies status and the service supply including service amount and service fees at the county level.3. The impact of operating financial subsidy on service amount and service costs by single factor analysis.4. The impact of operating financial subsidy on service amount and service costs by multivariate regression analysis.5. Policy Suggestions to optimize the public hospital operating financial subsidies policy.MethodsThis article mainly adopts the method of quantitative research.Firstlywe collect the relevant literatures from domestic and foreign to make a literature review, then we make a theoretical framework through theoretical basis of hospital operating financial subsidies. Secondly we explore the current situation of public hospital operating financial subsidies status by descriptive statistics method; then make a stratification analysis to confounding factors of the operating subsidy, using the variance and correlation analysis to explore the operating subsidy affection on services and service costs; Finally the multiple regression analysis model is established using balanced panel data to describe main impact on the service amount and service fees.Findings1. According to the literature analysis and the theory of Planned behavior Theory (TPB), on the premise of regulation in place, if given a sufficient number of subsidies and hospital management autonomy, the hospital will have larger behavior change intentions, by redesigning incentive and constraint mechanism. Finally the behavior of the medical staff will be changed, resulting in the change of the hospital service and service fees.2. Public hospitals financial aid at the county level increases year by year, but it never become the main source of revenue. The operating subsidy financial is also increasing year by year, the operating subsidy ratio of hospital financial aid has reached more than half in 2015, over 90 percentage of the operating subsidy was personnel grants.3.Thehospital services amounts exist differences between different subsidy ratio groups, and the differences are more obvious in eastern region and middle and small hospitals; There are positive correlation between hospital operating subsidy and hospital services amounts, in the case of other conditions unchanged, an increase of 10 thousand yuan operating subsidieseach, the hospital will raise 28work equivalent.4. The hospital services costs exist differences between different subsidy ratio groups, and the differences are more obvious in eastern region and middle and small hospitals; There are negative correlation between hospital operating subsidy ratio and hospital services costs, in the case of other conditions remain unchanged, an increase of 1 percentage operating subsidiesratio each, the cost of per inpatient will decrease 0.83 yuan and the average hospitalization expenses will decrease 48.42 yuan.Conclusions1. There is a rationality of hospital operating financial at country level inboththeory and policy, and it hascertain feasibilityon both policy environment and practice operation.2. The main problem of the operating subsidy at country level including the lack of maneuverability, the low level of practical subsidies, the poor efficiency of practical effects, the large difference between regions. At the same time the rapidly rising health care costs has also weakened the operating subsidy effects.3. The hospital operating subsidy can improve economic operation of public hospitals at the county level, increase the service supply, and reduce per service charges, but the overall effect of this role is limited.Suggestions1. To set standard, make the hospital operating financial subsidy at country level have clear regulations to enforce it.2. To implement the policies of operating subsidy and establish a long-termfinancial aid mechanism.3. To make innovation methods of operating subsidy, improve the performance management ofthe financial aid funds and establish tracing accountabilitymechanism.4. Adjusting the subsidy structure, Pilot projects will be launched for hospital operating subsidy at country level when conditions are ripe.