Research On Compensation Mechanism Of Public Hospitals Based On Cancellation Of Drug Addition

Public hospitals are the mainstay of China's medical service supply market.The reform of public hospitals is the key to the success of China's medical reform.At this stage,public hospitals across the country have carried out comprehensive reforms to eliminate drug additions and strengthen the public welfare attributes of public hospitals;in accordance with the path of “taking space,adjusting structure,and ensuring convergence”,the compensation channels for public hospitals will be adjusted from service charges,drug income and government subsidies to service charges and government compensation.However,the problems of “expensive medical treatment” and excessive medical treatment derived from drug add-on need to be further resolved;the contradiction between the supply and demand of medical services is escalating,and how to make reasonable compensation after the adjustment of the compensation channel of public hospitals needs to be dealt with.From the perspective of the medical side,this study analyzes the status quo and problems of the compensation mechanism of public hospitals based on the background of drug elimination,and explores ways to improve the compensation mechanism.Firstly,through reviewing relevant policy documents and academic literature,it analyzes the rationality and impact of the drug add-in policy being banned;understands the compensation mechanism model of public hospitals at home and abroad,and draws on the domestic historical experience and the development of foreign compensation models,and draw on the historical experience of the country and the development of foreign compensation models to enrich the theoretical basis and practical experience of the research on the compensation mechanism of public hospitals in China.Secondly,using descriptive statistics to analyze the relevant data of the “Wuhan Health and Family Planning Yearbook” from 2012 to 2016,and summarizing the current status and problems of compensation before the cancellation of drug addition in public hospitals in Wuhan.According to the yearbook data,the structure of the compensation mechanism of public hospitals in Wuhan is unreasonable.The proportion of fiscal compensation income in total income is less than 8%,and the government's financial investment is seriously insufficient;medical income accounts for about 89% of total income,pharmaceutical income accounts for a large proportion of total income,and medical service income cannot support the cost of medical business development;other income accounts for about 2% of the total income,and has little effect on public hospitals.Finally,using the system dynamics theory and method to analyze the compensation mechanism of public hospitals in Wuhan;the system dynamics Vensim PLE 7.3.4 software platform is used to draw the causal relationship diagram and system flow diagram of the public hospital compensation mechanism,and the system model is constructed.Then the simulation and policy intervention experiments are carried out,and the results are quantitatively analyzed.The following conclusions are drawn: the part of the public hospitals that have lost the drug revenue lost by the drug addition must be compensated by various methods such as strengthening financial support,adjusting the price of medical services,and attracting social donations.