The Impact Of Abolishing Drug Make-up On Public Medical Institution Income Structure In Shanxi Province

Objective:Be based on the research of income and income structure of public medical institutions to understand the influence of medical reform policy on them from 2010 to 2015 in Shanxi Province and to provide the scientific evidence for the medical institution income structure adjustment.Understand the difference of income structure in different levels public medical institution,analyze the practical effect of health care reform objectively and explore the problems existing in the reform process in order to promote and improve health care reform further to provide policy advice.Build and improve basic medical and health system and the hospital income management to provide a scientific basis.Methods:Data is about the comprehensive tertiary hospital,county hospital and township health centers which were implemented the health care reform policy and hosted by health administrative departments and from the "Shanxi provincial health and Family Planning Commission-medical and health institutions annual report" from 2010 to 2015 years.Describe,compare and analyze the income of different levels of hospitals.Using dynamic series to analyze the income status and its changing trend of the 3 medical institutions in Shanxi province.Results:The total income and expenses increased year by year from 2010 to 2015 and total revenues were higher than the total expenditure except 2011.Medical income and costs rise with the year,but medical balance decreased year by year.Clinic revenue increased year by year,but the growth rate decreased year by year,and decreased greatly.Clinic drug income increased year by year.Hospital income and hospital drug income increased year by year from 2012 to 2014 years,declined slightly in 2015.The ratio of hospital drug income declined year by year.Hospital examination income and its proportion in hospital income were increased year by year.Drug revenue and expenditure surplus and its proportion in total income decreased year by year.The average fiscal subsidy income increased year by year and its proportion fluctuated reaching the highest in 6 years in 2015.The medical balance was decreasing year by year in the tertiary hospital.Clinic drug income and hospital drug income were increased year by year from 2010 to 2014 and decreased slightly in 2015.The proportion of hospital drug income decreased year by year,but hospital examination income increased year by year and its proportion in hospital income was in a rising trend,and the growth rate is still on the rise.The proportion of drug balance in total income was declining year by year.Financial subsidy income showed a rising trend generally,and its proportion was up and down.The proportion of examination income was maximum in tertiary hospital and secondary in county hospital,the township health centers was the lowest.Clinic drug income increased year by year in county hospital but it was an downward trend in the ratio of clinic income overall.The proportion of hospital drug income decreased year by year.Hospital examination income and its proportion all increased year by year.The proportion of drug balance decreased year by year.Financial subsidy income was rising year by year,however,the proportion of financial subsidies dropped slightly in 2011 and 2014.Township health centers operated at a serious losses because medical income is less than the medical expenditure from 2011 to 2015.Clinic drug income and its ratio showed a rising trend year by year.Financial subsidy income and its proportion of gross income showed a rising trend year by year.The proportion of drug income and financial subsidy income were the highest in township health centers.Income of the tertiary hospital and township health centers in Shanxi Province was lower than the national level in the overall,but the income of county hospital was higher than the national level.Conclusion:The impact of abolishing drug make-up had a little effect on the income structure of tertiary hospitals,so the policy of abolishing drug make-up also need to promote and implement further.The impact of abolishing drug make-up had positive effects on the proportion of hospital drugs,drug balance and financial subsidy income of the county hospital,showing that abolishing drug make-up had a better implementation in the county hospital.Township health centers still relied on the drug income seriously,so medical equipment should be recommended to invested more and sink the superior hospital quality resources to the basic medical and health institutions to enhance the care services ability of township health centers overall.