Evaluation Of The Effect Of Comprehensive Zero-drug Reform On Tertiary Hospitals In Urumqi,Xinjiang

Objective: From the perspectives of hospitals,medical staff,and patients,through the analysis of the operating conditions of the tertiary hospitals in Urumqi,investigation and research on the policy cognition and satisfaction of medical staff and patients,Comprehensively discuss the specific effects of the three-level hospitals in Urumqi after the implementation of the zero drug addition,with a view to providing reference for the next step of the reform.Methods: Collected relevant reform measures in Urumqi region,collated the operating data of five tertiary hospitals for the three years from 2016 to 2018,including hospital medical service provision and operating efficiency,total revenue and expenditure,and key indicators like medicine ratio,compensation status,and changes in medical expense structure,combined with questionnaire analysis,summarizes the current situation of reform in Urumqi.Results:(1)After the implementation of the reform in Urumqi,experts discussed and the adjustment of prices of different medical service items were Realized,with zero markup on drugs;The overall revenue and expenditure of the five tertiary hospitals have improved,Service volume has increased;and medical income has increased steadily;The government has increased fiscal investment,and the proportion of medicines has dropped significantly.Two hospitals account for 30% of medicines ratio below the policy target,the ratio of medical service fees has been improved;the structure of medical fees has been optimized accordingly,the inpatient cost structure has changed more than outpatients,and the overall economic operation of each hospital is good.(2)Research has shown,88.33% of medical staff understand the implementation of the policy,45.34% of medical staff think that it has an impact on their diagnosis and treatment behavior,63.34% of medical staff think that it has an impact on the operation of the hospital;Professional titles and academic qualifications are influencing factors of medical staff's cognitive differences on the zero-plus drug comprehensive reform.and 54.00% of medical staff are satisfied with the implementation of the policy.Positions is the factor that affect the overall satisfaction of medical staff after the reform.(3)The control of theaverage cost of outpatients and inpatients in the five hospitals is not ideal,which is higher than before the implementation of the policy,but the average cost of medicines has decreased.The results of the questionnaire show that patients have a low level of understanding of policies.14.33% of patients understand policies;56.00% of patients are satisfied with the effect of policy implementation;the education level and policy awareness are factors that affect patient satisfaction.Conclusion: Judging from the effects of the reform in Urumqi,the economic operation of the tertiary hospitals is stable,Medical staff and patients are satisfied with reform,the patient policy perception rate is low,and the patient's medical burden is an issue worth watching.It is suggested that the next step is to subdivide the price of medical services,strengthen cost control,continuously optimize the salary and performance evaluation mechanism of medical staff,and strengthen coordination and communication with the medical insurance department.It really need focuses on reducing the patient's medical burden and satisfaction with the medical reform,and constantly improves the mass medical satisfaction.