Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (9): 95-102.doi: 10.6040/j.issn.1671-7554.0.2020.0581

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Influence of compensation mechanism reform on the hospitalization expenses of a county-level public hospital in Shandong Province

JIANG Xiaofeng1,2, YAO Jingjing1, ZHU Dawei3, HE Ping3, SHI Xuefeng4, MENG Qingyue3   

  1. 1.School of Health Care Management, Shandong University, NHC Key Lab of Health Economics and Policy Research(Shandong University), Jinan 250012, Shandong, China;
    2.Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    3. China Center for Health Development Studies, Peking University, Beijing 100020, China;
    4. School of Management, Beijing University of Chinese Medicine, Beijing 100029, China
  • Online:2020-09-10 Published:2020-08-30

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Abstract: Objective To analyze the impact of compensation mechanism reform on the per-visit inpatient services in a county-level public hospital in Shandong Province, and offer evidence for further development and adjustment of the reform. Methods Interrupted time series segmented regression model was used to analyze the instant change which took place on October 1, 2014 and trend of per-visit inpatient expense, hospital stay and surgical rate, based on data of diabetes, pneumonia, appendicitis and lumbar discherniation collected from a county-level public hospital in Shandong Province. Results After the reform, there were statistically significant in the changes of inpatient drug expense and medical service expense in this hospital; there were no statistical significance in the changes of per-visit inpatient expense, medical consumables expense and diagnosis expense; there were no statistical significance in the changes of hospital stay and surgical rate. Conclusion Although compensation mechanism reform reduces the per-visit inpatient drug expense, the trend of rising inpatient expense and other indicators have not been effectively controlled.

Key words: Compensation mechanism reform, County public hospital, Inpatient expense, Interrupted time series, Piecewise linear regression

CLC Number: 

  • R197.1
[1] 李卫平. 公立医院改革要从五方面着手[J]. 中国卫生经济,2010,29(3): 5-8. LI Weiping. Five measures for public hospital reform in China[J]. Chinese Health Economics, 2010, 29(3): 5-8.
[2] 山东省人民政府办公厅. 山东省人民政府办公厅关于推进县级公立医院综合改革的实施意见[EB/OL].(2014-08-13)[2020-04-13]. http://www.shandong.gov.cn/art/2014/8/13/art_2267_19873.html.
[3] 中华人民共和国国务院办公厅.国务院办公厅印发关于县级公立医院综合改革试点意见的通知[EB/OL].(2012-06-14)[2020-04-13]. http://www.gov.cn/zhengce/content/2012-06/14/content_6082.htm
[4] 翟婷婷,杨金侠,江洁. 取消“以药补医”县级公立医院的补偿机制改革研究[J]. 中国卫生事业管理,2013,30(2): 86-87. ZHAI Tingting, YANG Jinxia, JIANG Jie. Studying on reform on the compensation mechanism of “drugs to support medical services” in county state-owned hospitals[J]. The Chinese Health Service Management, 2013, 30(2): 86-87.
[5] 郑金坡,李军,马雷,等. 取消药品加成后天津某三甲医院住院费用分析[J]. 中国卫生事业管理,2018,35(12): 910-913. ZHENG Jinpo, LI Jun, MA Lei, et al. Analyzing the hospitalization expenses in a grade three and first-class hospital in Tianjin without added profit for pharmaceuticals[J]. The Chinese Health Service Management, 2018, 35(12):910-913.
[6] 刘建楠,周典. 城市公立医院综合改革前后住院费用比较分析——以安徽省某三甲医院为例[J]. 中国医院管理,2016,36(7): 23-25. LIU Jiannan, ZHOU Dian. Comparative analysis of the hospitalization expenses before and after the city-level public hospital reform:taking a third-level grade-A hospital in Anhui Province as an example[J]. Chinese Hospital Management, 2016, 36(7): 23-25.
[7] 潘悦华,崔梦迪,李雪辉. 药品零加成对医疗费用的影响及补偿机制探索[J]. 上海交通大学学报(医学版),2015,35(11):1696-1701. PAN Yuehua, CUI Mengdi, LI Xuehui. Study on effect of zero-profit medicine policy on medical expenses andcompensation mechanisms[J]. Journal of Shanghai Jiao Tong University Medical Science, 2015, 35(11):1696-1701.
[8] 李荏苒,孙利华,邢花. 基于河南省某试点县级公立医院“取消药品加成”政策实施效果研究[J]. 中国药学杂志,2017,52(15):1367-1372. LI Renran, SUN Lihua, XING Hua. Investigation of drug zero bonus present situation in a county-level public hospital in Henan Province[J]. Chinese Pharmaceutical Journal, 2017, 52(15): 1367-1372.
[9] 沈荣生. 公立医院改革药品零差率后对药品使用的影响[J]. 中国医院, 2013, 17(1): 62-63. SHEN Rongsheng. Impact of drug zero-mark up sale reform on drug use in public hospital[J]. Chinese Hospitals, 2013, 17(1): 62-63.
[10] 张维斌. 县级公立医院药事服务费政策效果分析——以重庆市5区县为例[J]. 中国卫生政策研究, 2017, 10(2): 27-31. ZHANG Weibin. The effects of pharmaceutical service fee policy on the county-level public hospitals: a case study of five counties(districts)in Chongqing[J]. Chinese Journal of Health Policy, 2017, 10(2): 27-31.
[11] 杨练,谭玲,李见,等. 四川省县级公立医院药品零差率政策效果评价研究[J]. 中国卫生事业管理, 2015, 6: 429-433. YANG Lian, TAN Ling, LI Jian, et al. Analyzing the effects of implement the zero-markup drug policy in county-level public hospital in Sichuan Province[J]. The Chinese Health Service Management, 2015, 6: 429-433.
[12] 何振仿,丁宏,李晓峰,等. 安徽省县级公立医院实施药品零差率政策效果评价[J]. 中国卫生事业管理, 2014, 8: 590-592. HE Zhenfang, DING Hong, LI Xiaofeng, et al. Evaluation of the zero-profit drug policy implement in the county public hospitals of Anhui Province[J]. The Chinese Health Service Management, 2014, 8: 590-592.
[13] 周书铎,马晓晨,袁蓓蓓,等. 北京市医药分开综合改革对大型检查设备使用情况的影响研究[J]. 中国卫生经济, 2019, 38(9): 22-26. ZHOU Shuduo, MA Xiaochen, YUAN Beibei, et al. Research on the comprehensive reform impact of separation of prescribing and dispensing on the usage of large-scale inspection equipment[J]. Chinese Health Economics, 2019, 38(9): 22-26.
[14] 庄昱,董书,吴昕霞. 北京市医药分开综合改革对某三级综合医院门诊服务利用的影响[J]. 医学与社会, 2020, 33(2): 53-57. ZHUANG Yu, DONG Shu, WU Xinxia. Impact of comprehensive reform of separation of medical treatment and drug sales on utilization of outpatient services in a tertiary general hospital in Beijing[J]. Medicine and Society, 2020, 33(2): 53-57.
[15] 段烁云,荣雪菁,孙强. 基于间断时间序列的山东省低价药政策实施效果评价[J]. 中国卫生政策研究, 2019, 12(2): 22-26. DUAN Shuoyun, RONG Xuejing, SUN Qiang. Discontinuous time series evaluation of the implementation effect of low-priced medicine policy in Shandong Province[J]. Chinese Journal of Health Policy, 2019, 12(2): 22-26.
[16] 张璐,许敏旋,杨晓雪. 基于准试验设计的公立医院收入补偿情况分析——以山东省某三甲医院为例[J]. 山东大学学报(医学版), 2019, 57(3): 109-114. ZHANG Lu, XU Minxuan, YANG Xiaoxue, et al. An analysis of income compensation of public hospitalsbased on a quasi-experimental design—a case study of a first-class hospital in Shandong Province[J]. Journal of Shandong University(Health Sciences), 2019, 57(3): 109-114.
[17] 常宝松,郭娜,陈丽,等. 补偿机制改革对县医院医疗服务利用情况的影响分析[J]. 中国社会医学杂志,2019,36(3):299-301. CHANG Baosong, GUO Na, CHEN Li, et al. Analysis of the impact of compensation mechanism reform on medical service utilization of county-level public hospitals[J].Chinese Journal of Social Medicine, 2019, 36(3): 299-301.
[18] 朱星月,林腾飞,米源,等. 间断时间序列模型及其在卫生政策干预效果评价中的应用[J]. 中国药事, 2018, 32(11): 1531-1540. ZHU Xingyue, LIN Tengfei, MI Yuan, et al. Interrupted tme series model and its application in effect evaluation of health policy intervention[J]. Chinese Pharmaceutical Affairs, 2018, 32(11): 1531-1540.
[19] Zhou ZL, Su YF, Campbell B, et al. The financial impact of the ‘zero-markup policy for essential drugs’ on patients in county hospitals in Western Rural China[J]. PLoS One, 2015, 10(3): e0121630. doi: 10.1371/journal.pone.0121630.
[20] He YZ, Dou GS, Huang QY, et al.Does the leading pharmaceutical reform in China really solve the issue of overly expensive healthcare services? Evidence from an empirical study[J]. PLoS One, 2018, 13(1): e0190320. doi: 10.1371/journal.pone.0190320.
[21] Fu HQ, Li L, Yip W. Intended and unintended impacts of price changes for drugs and medical services: evidence from China[J]. Social Science & Medicine, 2018, 211: 114-122. doi: 10.1016/j.socscimed.2018.06.007.
[22] 郭成杰,唐诗,陈昌锋. 徐州市县级公立医院药品零加成改革效果评估分析[J]. 中国农村卫生事业管理, 2016, 36(7): 828-830. GUO Chengjie, TANG Shi, CHEN Changfeng. Evaluation and analysis on the effect of zero-profit medicine policy reform in Xuzhou county level public hospitals[J]. Chinese Rural Health Service Administration, 2016, 36(7): 828-830.
[23] 庄园,马爱霞. 公立医院药品“零差率”对药品使用和销售影响的文献分析[J]. 中国医院, 2016, 20(9): 23-25. ZHUANG Yuan, MA Aixia. Literature analysis on the influence of drug zero markup in public hospital on drug use and sale[J]. Chinese Hospitals, 2016, 20(9): 23-25.
[24] 彭颖,李芬,金春林. 取消药品加成后医疗服务价格调整的实践与思考[J]. 中国卫生资源, 2014, 17(6): 419-421. PENG Ying, LI Fen, JIN Chunlin. Practice and consideration of medical service price adjustment based on the cancellation of drug markup[J]. Chinses Health Resources, 2014, 17(6): 419-421.
[25] 周忠良,苏延芳,周志英,等. 基本药物“零差率”政策对住院费用的影响——基于陕西省县级公立医院的研究[J]. 中国卫生政策研究,2013,6(12):25-32. ZHOU Zhongliang, SU Yanfang, ZHOU Zhiying, et al. The impact of zero-markup drug policy on inpatient expenditure: evidence from county publichospital in Shaanxi Province[J]. Chinese Journal of Health Policy, 2013, 6(12): 25-32.
[26] 李芬,彭颖,金春林,等. 实行药品零差率后公立医院补偿机制改革的探索及启示[J]. 中华医院管理杂志, 2015, 31(3): 164-166. LI Fen, PENG Ying, JIN Chunlin, et al. Exploration and enlightenment of the compensation mechanism reform featuring drug sale with zero makeup[J]. Chinese Journal of Hospital Administration, 2015, 31(3): 164-166.
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