| The reform of compensation mechanism in public hospitals is an important part of China’s medical and health system reform.It plays a key role in safeguarding the public welfare of public health care.It is generally believed that the compensation channels of public hospitals are mainly composed of three major parts:medical service,drug addition and government subsidy.After the market-oriented reforms in the medical and health field,because of inadequate government grants,underpriced medical services and other reasons,causes hospitals to make up for costs only through drug additions,which also contributed to the induction of excessive medical behavior,gradually against the public welfare of public hospitals,bringing a series of social problems.The "zero-markup" drugs policy attempts to solve this problem.However,adjusting the price of medical services and increasing government subsidies can not completely fill the gap caused by the cancellation of drug addition,which not only causes business difficulties in public hospitals,but also does not significantly reduce the total cost of health care.Then,Then,under the background of the full era of"zero-markup" drugs,how to guarantee the normal operation and development of the hospital,through deepening the reform of the compensation mechanism of public hospital incentives for hospitals to improve operational efficiency,improve service quality and control medical costs rising too fast has become an important topic in the current medical system reform.This study starts from the definition of economics and builds a research framework for the compensation mechanism of public hospitals.Through the study of supplier induced demand theory,economic mechanism design theory and different compensation methods,it was verified that the incentive compatible compensation method is the key to over-treatment of medical treatment.At the same time,it has obtained a set of evaluation methods and design methods for public hospital compensation mechanisms.Through the comparative study of the two international mainstream compensation mechanism models,the basic characteristics of the compensation mechanism of public hospitals are obtained through the comparative study of financial compensation and double compensation.Based on the above research results,this research constructs a public hospital compensation mechanism analysis framework composed of three aspects:describing the status quo,evaluating the advantages and disadvantages and finding problems.This study systematically analyzed the historical evolution and development status of public hospitals’ compensation mechanisms in China,and used the analysis framework proposed in this study to analyze the relevant operational data of the top four comprehensive public hospitals in Ningbo from 2010 to 2016.The empirical research on the operating performance of the public hospital’s compensation mechanism is mainly carried out from four perspectives:safeguarding the hospital’s normal operation,controlling the cost up too quickly,curbing excessive medical behaviors and improving the performance of medical services.The results show that there are many problems in the compensation mechanism of public hospitals,such as insufficient financial compensation,inadequate payment system,heavy burden of individual medical care and defects in the pricing mechanism of medical services.Based on theoretical research and empirical research,this study considers that the path of public hospital compensation mechanism reform should be selected from the combination of medical insurance payment and financial compensation dual compensation model in the era of zero-markup drugs.Under the social medical insurance system,a new type of public hospital compensation mechanism model with the main part of the medical insurance payment system,the hospital performance evaluation system and the medical price system is constructed,and targeted countermeasure proposals are proposed around this model. |
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