Study On The Inlfuence Of Zero-profit Drug Policy On The Economic Operation And Medical Expenses Of Primary Health Care Institutions

Objective:Zero-profit drug policy as a breakthrough in the national essential drugsystem, has been achieved preliminary results in Anhui Province, and has been fullyopened in the province’s primary health care sector. The policy canceled the drugaddition of primary medical institutions, drug sales profit depends on the governmentto give financial compensation, so it is inevitable to have a certain impact on the“drugs to support medical” model of primary health care institutions. The paperanalyses the overall operational status of the primary health care institutions, andcurrent situation of financial compensation before and after the implementation of thezero-profit drug policy, to provide a theoretical basis for the further reform of theprice of medical services; analyses the proportion of the revenue structure of medicalservices and medicines of primary health care institutions around zero-profit drugpolicy, to explore the impact of zero-profit drug policy on the medical costs and theeconomic operation of the primary health care sector.Method:By using Excel2010to do the statistical analysis of survey data, the papercompares the changes of revenue and expenditure composition and medical servicesof primary health care sector in two years before and after the implementation of the zero-profit drug policy; and through expert consultation and on-site discussion, tounderstand and compare health care reform-related policies and measures.Result:(1)Various types of income from medical institutions have showed the overalldownward trend, but the balance dramatically increases. Regionally, the number ofprofit institutions has increased, the increase in the balance institutions accounted for70%;(2)Fixed assets and net growth rates of medical institutions are decreased by99%and98%, the fixed asset investment is basically stagnant. However, the debtratio declined by34%, institution debt situation has gotten a certainmitigation;(3)Average drug fee of outpatient and inpatient declined by3%and17%.However, the cost of outpatient visits increased, meanwhile, outpatients andemergency patients and the bed occupancy rate decreased by25%and35%respectively;(4)Drug revenues accounted for the proportion of business income andmedical revenue remained at about50%, far higher than20%of the worldwidestandard,"drugs to support medical" status has not been significantly improved.Conclusion:The government should improve the compensation mechanism; usingmulti-channel combined compensation to estimate the amount of compensationreasonably, and to ensure that compensation is in time and in full; Primary health caresector and the higher health authorities should strengthen the policy advocacy andsupervision and management, guide the medical staff to use zero-profit drugspreferentially and rationally, to prevent unreasonable growth of the examination andother medical expenses. Primary health care institutions should also strengthenbringing in qualified personnel and advanced technology, allocate the health resources rationally, and optimize the quality of service to prevent the high-levelhospitals overcrowded.