Evaluation And Analysis Of The Comprehensive Medical Price Reform Of County Public Hospitals In Guangxi Zhuang Autonomous Region

Objective To investigate the progress and effect of the comprehensive reforms of medical prices at county-level public hospitals across the region,the existing difficulties and problems,to accumulate experience for reforms,and provide some evidence for the improvement of policies;to carry out evaluations of effects to further comprehensively deepen the comprehensive reform of public hospitals at the county level policy suggestion in Guangxi.Methods A sample survey method was used to collect 21 county level public hospitals before and after medical reform in Guangxi and descriptive analysis was used to evaluate the trends in the statistics.The survey mainly includes the implementation and progress of the policy reform of pharmaceutical prices at county level public hospitals,the changes of drugs price difference rate,income and expenditure structure,average expenditure of patients and the effectiveness and problems of reform.Results The gross profit of drugs before the reform was 12.95%,and In2016 it fell to 0.98%.The overall decline rate was 12%.The overall price difference of medicines decreased,and the gross profit of medicines plummeted.In 2012,the average medicine proportion of hospitals was 35.96%.Afterwards,it decreased year by year.In 2016,it was 25.98%,a drop of 27.75%.In 2016,the hospital’s average balance of payments was 5.784 million yuan,compared to2012,it has an increase of 145,000 yuan,an increase of 2.57%,and an average annual growth rate of 0.60%.The hospital’s income and expenditures have increased year by year with a slight surplus.Government subsidies have been implemented.The price adjustment compensation rate and the government’s financial subsidies have met the policy requirements.The average medical insurance fund balance in 2012 was 2.481 million yuan,and in 2016 it was2.984 million yuan,has an increase of 20.3%,with an average annual growth rate of 4.7%,the health insurance fund operated stably with a slight balance;the per capita medical insurance expenditure in 2012 was 957.0 yuan,and in 2016 it was 1008.3 yuan,an increase of 5.4%,with an average annual growth rate of1.3%;2012 The per capita hospitalization medical insurance expenditure was1982.6 yuan,in 2016 it was 2422.9 yuan,it has an increase of 22.2%,with an average annual growth rate of 5.1%;in 2012,the patient’s own expenses ratio was 47.6%;in 2016,it was 41.2%,which was a drop of 6.4%;outpatient and hospitalization expenditure increased year by year,The cost goes up Per capita health care costs are rising,and the out of pocket health payment rate slightly decreased.The proportion of medical service revenue rose,the hospital’s income structure has been optimized,medical service and medical service capacity improved.Conclusion The policy implementation is in place,and the implementation performance is good;the drug occupation ratio steadily decreased,the drug fee control is remarkable;the service quantity and quality is steadily increased,the service capacity has been improved;the balance ofincome and expenditure is stable,the income structure is optimized;the proportion of medical insurance payment is stable,and the financial burden of patients has alleviated.But the price of medical service is too high,the government financial subsidy lacks of precision;the outpatient and hospitalization expenses are increasing rapidly,the cost of the patient is increasing;the balance of medical insurance fund has declined,and there exists a certain risk;the innovation of the reform needs to be strengthened;the reform supporting policies needs more enhanced.