Investigation And Evaluation Of The Effect Of The Policy Elimination Of Drug Addition In Public Chinese Medicine Hospital In Guangdong Province

ObjectiveTo investigate and analyse Guangdong public traditional Chinese medicine hospitals’ implementational results of the policy elimination of drug addition in the comprehensive reform,comprehensively master the elimination of drug addition to the status quo.To put forward the suggestion measures to promote the implementation of the policy elimination of drug addition in view of the problems existing in the implementation process of the elimination of drug addition in Guangdong public medicine hospital.MethodsLiterature retrieval method: Collect literatures about the policy elimination of drug addition of China and the laws,regulations and policies related to the comprehensive reform of public hospitals and the policy elimination of drug addition.Retrieve PubMed,Springerlink website to collect the literatures about hospital reform and medical system of foreign medical institutions.Sort out the literatures to comprehend the present situation about drug system and the control of the costs of drug.Consult foreign advanced experience and provide experience for the reform of Guangdong province in China.Statistical analysis: use Excel to establish database,use statistical software SPSS22.0 to analyze data.Do the statistical analysis of qualitative and quantitative for the relevant data of TCM hospital,(including all the public TCM hospitals in the Guangdong province,eight sample county-level public TCM hospitals and seven sample urban public TCM hospitals.)Compare hospital running situation before and after the reform through the analysis and analyze the implementation results of the policy elimination of drug addition and its influencing factors.ResultsAfter the policy elimination of drug addition,the medical service quantity of Guangdong public traditional Chinese medicine hospitals are not affected.After the reform,the number of patients in the emergency room increases year by year,the annual growth rate of the hospital discharges and admissions’ growth rate is 9.6% 4 years after the reform.The medical income and expenditure structure is good.After reform,the income and expenditure are balanced with slight surplus,the remaining balance is around 2%.The income structure has changed,in which the proportion of inpatient medicine income falls by nearly 4%,the proportion of labor service value of medical staff improves,the proportion of outpatient diagnosis income increases by 0.5%,the proportion of inpatient diagnosis income increases by 0.2%,the proportion of average inpatient drugs decreases from 33.7% in 2010 to 29% in 2016,but the average burden of patients increases year by year,average cost of diagnosis and treatment increases from 141.6 yuan in 2010 to 218.3 yuan in 2016,average cost of hospitalization increases from 7793.1 yuan in 2010 to 10863.4 yuan in 2016.The proportion of average outpatient drugs decreases not significantly,the proportion of average cost of diagnosis and treatment of outpatients decreases from 17.5% to 12.9%.The proportion of average inpatient surgery cost decreases from 10.2% to 6.4%.About the sample hospitals,the surplus rate of county-level public TCM hospitals decreases from 2.05% in 2012 to 1.02% in 2016,during which the surplus of 2016 is minus,showing that hospital operating loss.After the reform of urban public hospitals,half the hospitals’ surplus rate are lower than before reform,only one hospital’s income is greater than expenditure.After the reform,the proportion of total medicine and inpatient income decreased significantly,especially the proportion of inpatients’ drug income,the proportion of drug of medical income in county-level hospital decreases by nearly 8%,the proportion of inpatient drugs decreases by nearly 9%,the proportion of average inpatient drugs decreases by nearly 8%.But the proportion of laboratory income increases by nearly 3% within 5 years,the income of medical consumables increases by nearly 3%,the average cost of outpatients increases 20.63 yuan and outpatients increases 829.15 yuan,the average cost of hospital bed cost increases 157.03 yuan.The proportion of drug decreases obviously after the reform of urban public hospitals,the decline of proportion of drug income of medical is between 1%-5%,the decline of proportion of drug income of inpatient is between 1%-5%,the decline of proportion of drug income of average inpatient is between 4%-10%,but the growth of laboratory income of mostly hospitals is between 0.1-0.3%,the proportion of outpatient drug income and the proportion of average outpatient drug income and average cost of hospital bed rises.ConclusionAfter the policy elimination of drug addition,the medical treatment quantity of public medicine hospital in Guangdong is not affected.The proportion of drug and the proportion of drug income of inpatients and the income which reflects medical staff’s labor value increase.But there are problems: The proportion of the income of health materials and examination is increasing year by year;The average cost of patients is increased and the proportion of drugs is still large and the rising of the discharge’s daily cost per hospital bed is obvious.But average cost of diagnosis which reflects medical staff’s labor value and surgery cost show a downward trend.The public Chinese medicine hospital in Guangdong province needs to promote the reform of compensation mechanism and improve the compensation level of labor service value of medical staff.Find out the effective reform methods,apply modern hospital management mode to improve management level and the ability of TCM service;Strengthen the construction of the talent team of TCM and corresponde hierarchical medical system to reduce the burden of medical personnel.Government should propel the reform of public hospitals,at the same time with paying attention to supporting policies,such as the reform of the mode of payment,improve the system of medicine circulation system of supervision and establish mechanisms for financial aid long-term running policy.