Study On Optimizing The Income Structure Of A Third-Class A Hospital Based On The Analysis Of Operational Indicators Under The Reform Of Drug Zero Difference Rate

Objective Based on the background of drug zero-margin reform,this study analyzed the current situation of the operation and development of the tertiary and first-class hospitals in H city,explored how to Broaden sources of income and reduce expenditure in the context of medical reform,At the same time,it formulated a series of coping plans including refined operation management and cost control.This paper compares the changes of income structure before and after the implementation of the plan,and scientifically evaluated the effect of the plan,so as to provide public medicine.The hospital provides guidance and suggestions for improving operation efficiency,reducing costs and optimizing income structure.Method The research object of this subject is A tertiary first-class hospital in H city.Using quantitative and qualitative methods,from three perspectives of basic situation,income composition and cost composition,and taking the time of drug zero-difference rate reform as a node,the scientific effectiveness of the scheme is demonstrated by comparing and analyzing the changes of data indicators before and after the implementation of the scheme.Result The effect comparison of the hospital before and after the implementation of the zero profit drug reform program.(1)Analysis of the basic situation of hospitals,(1)Medical service workload: the total number of outpatient and emergency services increased by 8.60%,which is 9.70% higher than that of the same kind of public hospitals in China.The number of discharges increased by 6.40% year on year,which is3.70% higher than that of the same kind of public hospitals in China.The growth rate of operation tables was the highest,increasing by 14.00%year on year.(2)Overall operation: the number of outpatients per employee increased by 2.70% year on year,the number of discharges per employee increased by 0.60% year on year,and the number of turnover per bed increased by 3.20% year on year.The rate of bed utilization increased by 2.40% year on year,and the growth rate was 3.60% higher than that of third-level hospitals in China.The average length of stay in the hospital decreased by 0.10 days compared with the same period last year,Therefore,the overall operation of the hospital has improved However,the average hospitalization days are more than 10 days,which is higher than the average level of similar hospitals in China.(3)Key operating conditions: the per capita cost of outpatient service decreased by 1.10% compared with that of the same period before the implementation of the scheme,and the growth rate of comparable price was 0.60% under the influence of price.The growth rate was slower than that of tertiary hospitals in the whole country,and the cost amount was lower than that of the same hospitals in the whole country;the per capita cost of hospitalization decreased by 11.60% compared with that of the same period before the implementation of the scheme,and the comparable price increased under the influence of The growth rate is1.20%,which is faster than the average level of tertiary hospitals in China,and the cost is higher than the average level of similar hospitals in China.The average outpatient drug fee declined by 9.10% and the average hospitalization drug fee increased by 2.80%.(2)In terms of income composition,the hospital’s medical income was 2 billion 347 million yuan,up 15.90% year-on-year.The outpatient income accounted for30.30% of the medical income,down 1.70% year-on-year,and the hospitalization income increased 1.7%.The proportion of labor income increased by 0.7 0percentage points,while the proportion of drug income decreased by 3.40 percentage points.The proportion of total effective income to total income of departments increased,while the proportion of invalid income decreased.Total hospital revenue was 2 billion 394 million yuan,an increase of 16.53% year on year,and the balance of revenue and expenditure increased by 1.67% year on year.(3)From the cost point of view,the total cost of the hospital was 2 billion 71 million yuan,up 13.80% year-on-year,0.10% lower than that before and after the implementation of zero-margin rate,12.38% higher than that before and after the implementation of zero-margin rate,and 0.45% lower than that before and after the implementation of zero-interest rate.The cost of health materials is the slowest growth rate among the cost components,which is 9.21% lower than the growth rate before and after the implementation of zero interest rate.The cost of health materials consumed per 100 yuan of medical income(excluding drug income)tends to decrease after the implementation of the program,but there is still a gap from the policy requirement of 20 yuan.Unfortunately,the controllable cost of some clinical departments increased more than that of the previous year,and the cost of controllable cost control was not ideal.But in addition to the increase of controllable cost of medical and technological areas,the total controllable cost of hospitals,surgical areas,internal medicine areas and critical and critical areas all decreased compared with that before the implementation of the coping plan.Surgical areas declined 11.41%,medical films declined 45.08%,and critical and critical areas declined 5.99% compared with the previous year.Conclusion After the implementation of the plan,the hospital has basically achieved open source and reduced expenditure.Total income increased year-on-year,labor income increased significantly,the proportion of invalid income(drugs,health materials)slowed down,the proportion of effective income increased,the income structure tended to be coordinated,the operation of the program basically achieved results,to a certain extent,the hospital income composition was optimized,cost expenditure decreased,revenue and expenditure balance increased.