A Study On The Influence Of Comprehensive Reform Of Medical Price In Public Hospitals On Medical Expenses

Objective:Taking a tertiary first class hospital in Jilin Province as an example,the influence of the comprehensive reform of medical price in public hospitals on the medical expenses of public hospitals was observed,so as to provide information support for the further reform of hospital prices.Through data comparison and analysis,the effects of comprehensive reform of medical prices on the outpatient expenses and outpatient cost structure,the impact of comprehensive medical price reform on the hospitalization expenses and hospitalization expenses structure,and the impact of comprehensive reform of medical prices on medical insurance expenses were compiled.Actual operation and assessment of the effectiveness of policy implementation.Methods:This paper makes an on-the-spot investigation of a tertiary first-class hospital in Jilin Province,and collects the outpatient expenses,hospitalization expenses,medical insurance costs and expenses structure before and after the implementation of the medical price reform measures in public hospitals from March 2015 to February 2018.And collect the data of outpatient and inpatient expenses in the same period in the whole country.Group data by starting year.The annual growth rate is calculated in terms of growth rate: annual growth rate =(second year data-first year data)/ first year data x 100%.The structure of outpatient expenses,the structure of hospitalization expenses,and the changes of medical insurance expenses were compared in different years.Results:After the implementation of the drug price reform,the structure of outpatient expenses has changed.The cost structure of Chinese patent medicines,treatment costs,and Chinese herbal medicines,combined with laboratory fees and western medicine fees,has been changed to Chinese herbal medicines and proprietary Chinese medicines.Cost structure.After the implementation of the comprehensive reform of pharmaceutical prices,the cost of medicines in public hospital outpatient fees decreased significantly,and the cost of medical treatment showed a relatively obvious upward trend.The inspection fees,treatment fees,and laboratory fees showed a slight upward trend.The drug costs account for the largest proportion,followed by the inspection fee,again the laboratory fee and the treatment feeAfter the implementation of the drug price reform,the structure of hospitalization expenses has changed.The cost of proprietary Chinese medicines,treatment fees,and western medicines has been changed.The cost structure of laboratory fees,other fees,and Chinese herbal medicine fees has changed to Western medicine,treatment,and laboratory fees.Hospitalization fee structure.After the implementation of the drug price reform,the hospitalization expenses,the drug cost decline trend is obvious,the hospitalization expenses,laboratory fees,bed fees,treatment fees,inspection fees in hospitalization costs show different degrees of upward trend,according to the proportion: the proportion of drugs The largest,other costs are sorted from large to small: laboratory fees,treatment fees,other fees,inspection fees,surgery fees,bed fees,care costs.After the reform,the average increase rate of outpatient expenses of medical insurance patients in 2017 was significantly higher than that in 2016(P < 0.05),and the average increase rate of hospitalization expenses in 2017 after reform was significantly lower than that in 2016(P < 0.01).Conclusion:After the comprehensive reform of the medical price of public hospitals,the outpatients' expenses,hospitalization expenses and medical insurance expenses all decreased,and the comprehensive reform of the medical prices of the public hospitals had a decreasing effect on the out-patient expenses,the hospitalization expenses,the medical insurance expenses and the structure of the public hospitals.But it does not fundamentally control the growing trend of medical expenses.