Research On The Current Situation And Countermeasures Of "Expensive Medical Services" In Hebei Province

Objective:Combined with the medical and health background of He bei Province in the past decade,focusing on the basic situation and sub jective experience of residents in Hebei Province,this paper makes a sy stematic analysis of the current situation and influencing factors of the problem of "expensive medical services" in Hebei Province,and provide s reference suggestions for relevant management departments and the de velopment of China's health industry.Methods:1.By referring to China Statistical Yearbook,China Health Statistical Yearbook and Hebei health expense report,this paper makes descriptive statistical analysis on the total health expense,personal health expenditure,residents' health care expenditure,the proportion of living expenditure in consumption expenditure,and the change trend of per capita medical expense of outpatients and residents in hospitals in Hebei Province.2.Using the method of multi-stage random sampling,the residents were selected for questionnaire survey.Chi square test and chi square trend test were used for comparison between single factor groups,and logistic regression was used for multi factor analysis.3.Adopt one-to-one interview to interview stakeholders and special groups around the problem of "expensive medical services",and summarize and analyze the interview data.Result:1.From 2009 to 2018,the total health expenditure,per capita health expenditure and per capita personal cash health expenditure in Hebei Province showed an increasing trend year by year.The growth rate of per capita personal cash health expenditure is higher than that of per capita GDP of the whole province.From 2014 to 2018,the per capita medical expenses of outpatient and inpatient are increasing.In Hebei Province,the proportion of residents' living expenditure to consumption expenditure is decreasing,the proportion of health care expenditure to consumption expenditure is increasing,which is higher than the national average level,and the economic burden of residents' medical treatment is increasing year by year.2.72.9% of urban and rural residents in Hebei Province think that there is the problem of "expensive medical services".There were significant differences in cognition of "expensive medical services" among residents of different regions,ages,education levels and monthly incomes(P < 0.05).The highest proportion of residents in Tangshan,87.2%,followed by Zhangjiakou,70.3% and Xingtai,59.9%;with the increase of age,residents tend to think that there is no problem of "expensive medical services";residents with higher education tend to think that there is a problem of "expensive medical services";month The higher the income,the more likely it is to think that there is no problem of "expensive medical services".With the increase of the level of medical institutions,the proportion of residents who think that there is "expensive medical services" is also increasing;the higher the annual medical expenses,the higher the proportion of residents who think that there is "expensive medical services".The top three reasons that residents think "expensive to see a doctor" are high cost of examination,expensive drugs and high proportion of personal self payment.The proportion of each factor is 51.68%,48.22% and 32.52% respectively.3.Only 35.5% of the residents whose reimbursement rate is more than 50% in the interview with special population.The high cost of transportation,accommodation and work delay for some drugs not included in the reimbursement catalogue of medical insurance for serious diseases and medical treatment in other places is the main reason for the patients to think that "expensive medical services";the stakeholders think that "expensive medical services" is a relative concept of personal subjective feelings,and the scope of medical insurance reimbursement is small,and drugs and consumables are expensive The high cumulative cost of chronic diseases is the main reason for the "expensive medical services".Conclusion:1.At present,the phenomenon that "expensive medical services" still exists in Hebei Province,and the patients with serious illness,serious illness and the people in different places feel the most obvious.2.The high cost of drugs and inspection is the direct reason for the "expensive medical services",and the high proportion of personal self payment is the fundamental reason for the "expensive medical services",while the imperfect hierarchical medical system is the institutional reason for the formation of the problem.3.Three To solve the problem of expensive medical treatment,three suggestions are put forward: to further improve the hierarchical diagnosis and treatment system,to implement small diseases in the grass-roots level and large diseases in the hospital,so as to reduce the excessive medical expenses;to improve the service ability of grass-roots health institutions,to solve the common diseases in the grass-roots level,so as to reduce the medical expenses;to control the price of drugs and inspection items,effectively reduce the direct medical expenses;to continuously improve medical treatment Guarantee level and coverage,reduce personal payment.