Data Monitoring Analysis Of 66 Hospitals In Hainan Province In 2016-2018

Objective:Data collection of hospitals with medical reform monitoring records for three consecutive years in 2016-2018 in cities and counties of Hainan Province under the background of new medical reform,the index changes of each city and county in the past three years were analyzed and compared from the aspects of medical income,average outpatient expenses,average inpatient expenses,medical service income and its proportion,drug proportion and the cost of health materials consumed by one hundred yuan medical income.In order to implement the policy and measures of medical reform,improve the control of medical expenses,and improve the efficiency of medical services,some suggestions are provided.Methods:Collect relevant data of 66 hospitals with medical reform monitoring records in 19 cities and counties of Hainan Province from January 2016 to December2018,It mainly includes medical income,outpatient income,outpatient income,inpatient income,inpatient income,drug income,etc.Under the guidance of the《implementation opinions of Hainan Province on controlling the unreasonable growth of medical expenses in public hospitals》,use the formula provided to calculate other index data,including medical service income and proportion,outpatient average cost,inpatient average cost,health material cost,health material cost and medicine proportion(excluding Chinese herbal pieces)consumed by 100 yuan medical income,etc.Using Excel software to build database and spss22.0 software to input and analyze data,descriptive statistics,analysis of variance and trend test are used for analysis.Results:1.Medicine proportion(excluding Chinese herbal pieces)is too high,in 2016and 2017,the proportion of drugs in all cities and counties(excluding Chinese herbal pieces)was almost more than 30%,which did not meet the expected target;by 2018,only 6 cities and counties accounted for less than 30% of drugs(excluding Chinese herbal pieces),however,the proportion of drugs in other cities and counties(excluding Chinese herbal pieces)is only a few percentage points more than 30%,which is greatly improved compared with the previous two years.2.Low value of medical services,16 out of 19 cities and counties showed an increasing trend of medical service revenue in 2016-2018,among them,5 cities and counties showed linear growth,but the proportion of medical service income in these five cities and counties is not linear growth,it can only be vaguely compared that the proportion of medical service income in 2018 is higher than that in the previous two years.3.The cost of health materials needs to be further reduced,in 2016-2018,in 19 cities and counties except Haikou City,the health materials consumed in the annual medical income of 100 yuan were higher than 20 yuan,other 18 cities and counties are less than 20 yuan,achieve the expected goal.However,in 10 cities and counties,the consumption of health materials in the 100 yuan medical income increased by a small margin,in the other six cities and counties,the consumption of health materials in the100 yuan medical income has a certain downward trend year by year.4.The increase of outpatient per capita cost and inpatient per capita cost is too high,only 6 cities and counties in 19 cities and counties showed a decrease in the growth rate of the average cost of outpatient services,the growth rate of per capita hospitalization expenses in four cities and counties decreased,failed to achieve the expected goal.5.The increase of total medical expenses is too high,from 2016 to 2017,the total medical expenses increased by 9.04% in tertiary hospitals and 11.64% in secondary hospitals,In 2017-2018,the growth rate of total medical expenses of tertiary hospitals was 6.13%,and that of secondary hospitals was 4.04%,there is a downward trend in the growth rate by 2018.Conclusions:In 2016-2018,the medical and health system reform in Hainan Province improved greatly,the main problem lies in the high increase of medical expenses,by controlling the indicators of medical expenses,we can achieve the goal of stabilizing the increase of medical expenses.1.Strengthen the concept of rational use of drugs and formulate assessment plan;2.Dynamic monitoring of drug information and use and establishment of feedback mechanism of drug dosage early warning system;3.Standardize clinical pathway,select consumables reasonably,and strengthen supervision on procurement and use of health materials,4.Improve the value of technical service of medical staff;5.Establishing the dynamic adjustment mechanism of medical service price;6.Actively respond to the implementation of DRGs.