The Medical Pricing Reform In County Public Hospitals In Qidong,Jiangsu Province And Its Impact On Medical Expenses

ObjectivesTo build a analysis framework by reviewing and integrating the concepts,related theories and researches in China and abroad of medical pricing reform and medical expenses;To understand the policy and implementing situation of the medical price reform in the county public hospitals in Qidong,Jiangsu Province;To analyze the impact of the reform on medical expenses;To analyze the existing problems and put forward corresponding suggestions.Contents1.Elaborate the policy and implementing situation of the medical price reform in the county public hospitals in Qidong,Jiangsu Province.2.Analyze the impact of the medical pricing reform on medical expenses.3.Analyze the influence mechanism of medical pricing reform on medical expenses.4.Analyze the existing problems of medical pricing reform and make recommendations.MethodsThis article takes a combination of quantitative research and qualitative research.Firstly,we collect the relevant literatures from domestic and foreign to review the concepts,related theories and build a analysis framework for the impact of medical pricing reform on medical expenditure.We use expert consultation method to rationalize the validity and availability of the medical expenses indicators.Secondly,we show the trend of the medical expenses by descriptive statistics method and explore the changes in the internal structure of medical expenses though the analysis method of structure variation degree.Finally,we analyze the influence mechanism of medical pricing peform on medical expenses based on rational choice theory.Findings1.The findings of the impact of the medical pricing reform on medical expenses:1.1 Total medical expenditure,outpatient/inpatient medical services per capita,out-of-pocket expenditure and Average expenses of typical single disease cases increased by 2015.The growth rate of total medical expenditure?outpatient/inpatient medical services per capita?out-of-pocket expenditure and Average expenses of typical single disease cases slowed sharply,and most of the costs showed a clear downward trend from January to October of 2016.1.2 The medical pricing reform of Qidong affected the internal changes in medical costs.The structure of medical expenses is changing from mainly consist of medicine expenses to mainly consist of examination expenses and diagnostic expenses.But drug proportion is still much higher than the 30%target of the policy.Surgery expenses and care expenses did not change significantly.Inspection expenses,laboratory test expenses and other expenses(such as health material expenses)may be the main constituent factors that impede the decline in medical expenses.2.The main pionts of the impact of medical pricing peform on medical expenses:2.1 Medical pricing peform controls the growth of medical expenses.2.2 Substantial zero rate of drugs can really squeeze drug price space.2.3 Medical service price adjustment is helpful to optimize the structure of medical expenses.2.4 Comprehensive target responsibility system plays an important role in controlling medical expenses.Conclusions1.The medical price reform of Qidong controls the growth rate of medical expenses.2.The medical price reform of Qidong makes the cost structure more reasonable.3.Cancelling the drug addition simply cannot reduce medical expenses fundamentally.4.Unreasonable price adjustment of medical services would raise medical expenses.5.Comprehensive target responsibility system is the main influence factor of medical expenses decline.Suggestions1.Medical service price adjustment process should be promoted further.2.Medical service price adjustment should be based on accurate measurement.3.A dynamic price adjustment mechanism for medical services should be established.4.Medical payment mode on medical service behavior should play a guiding function.