| BackgroundThe reform of the medical industry plays an important role in the society,which is related to the well-being of the people and the fundamental interests of the mass of the people.In recent years,medical expenses have been rising,the proportion of drugs in the expenditure is larger.Appealing for the cancellation of the drug addition policy is seriously,and the medical reform aims to break the mechanism of "drug supplement",adjusting the medical income structure,and fully reflect the labor value of the medical staff.Reform has been carried out in nationwide.There are national policies and local supporting measures in order to ensure and promote carry out the reform smoothly.The reform is mainly to promote the separation the drug in all public hospitals in the pilot cities,actively exploring various effective ways to reform the medical mechanism and abolishing the addition of drugs.The compensation for public hospitals is changed from three channels to two channels which are service charge and government subsidy.We should establish a scientific and reasonable compensation mechanism by adjusting the price of medical services,enhancing government investment,reforming payment methods,and reducing hospital operating costs.The reform has a significant impact on the economic operation of public hospitals,especially for Traditional Chinese medicine hospitals.Traditional Chinese medicine is a valuable asset in traditional Chinese culture.Traditional Chinese medicine has the advantage of "easy,convenient,effective and cheap".It plays an important role in the process of curing the disease and saving people,and the hospital of traditional Chinese medicine is also a powerful carrier of medical services.Our country takes great attention on the role of traditional Chinese medicine in the medical field.In the nineteen major reports,it is pointed out that"stick to the traditional Chinese medicine as important as the Western medicine,we should inherit and develop the traditional Chinese medicine".In the "healthy China 2030" program outline,it also proposes that we should improve the service capacity of Chinese medicine and strengthen the combination of traditional Chinese and Western medicine,and also develop characteristic rehabilitation services,and strive for the leading role of Chinese medicine in the prevention of disease in 2030.Therefore,it has profound significance to study the development of Chinese medicine hospital.In Shandong Province,the spirit of the State Council’s notice on the development of Chinese medicine development strategic plan is carried out.In the notice,it points that the health care service of traditional Chinese medicine is fully integrated into the construction of "healthy Shandong".Compared with western medicine,traditional Chinese medicine hospital has many problems,such as low level of medical technology,few methods of medical examination,high proportion of drug use,high cost of manpower,and weak compensation for medical.However,Chinese medicine hospitals are also playing an indelible role in providing medical services.The impact of the compensation policy reform on Chinese medicine hospitals needs to be analyzed and evaluated in urgent.At present,there are a lot of literatures on the compensation mechanism,but most of them are aimed at public hospitals,but the research on the hospital of traditional Chinese medicine is relatively small.Therefore,this study can enrich the research of the reform of the compensation mechanism in the hospital of traditional Chinese medicine;through the analysis of the case hospital,the measures and relevant policy suggestions are put forward.It has far-reaching significance to inherit and carry the culture of traditional Chinese medicine.ObjectiveThe purpose of this study is to analyze the influence of the reform of the compensation mechanism on the economic operation of the case hospital in Shandong Province,and to evaluate the influence of the reform on the case hospital by a series of economic indicators,so as to give some measures to the future development of the case hospital.Relevant suggestions are put forward for the compensation policy.MethodsBased on the influence of the policy elements of reform on the economic and economic operation of the case hospital,this study sets the corresponding economic indicators to reflect the effect and impact of the reform.The descriptive analysis method is used to compare and analyze the indicators of economic operation before and after the reform.analyze the changes of the structure of the outpatient and hospitalized income by the change of structure,the degree of change and the rate of contribution.Using Interrupted time-series analysis(ITSA)to compare the proportion of all kinds of drugs before and after the reform,and analyze whether the change has the immediate effect and the long-term effect.Results(1)The drug percentage of the case hospital is obviously lower than that before the reform.After the reform,the drug proportion(the proportion of the income of the western drug and Chinese patent medicine occupy the medical income)is about 35%,which is still slightly higher,but it has tended to be about 30%of the government requirement of the drug percentage.The drug percentage has the both of immediate and long-term effect.The increase of the proportion of Chinese herbs has long-term effects but don’t have immediate effects.The total income of drugs has immediate effect but has no long-term effect.The overall proportion of Chinese herbal medicine shows an upward trend,but the proportion in the medical income is not high,the average percentage is about 16%.(2)the proportion of drug income in the outpatient and hospital income is larger,the medical income of the case hospital is still relying on the drug income,the fluctuation of the structure of the outpatient income is 8.35%.The income of the drug,the inspection,and the laboratory are the main medical service items which cause the change of the outpatient income structure.The cumulative contribution rate of the 3 items is 79.69%.Drug income,laboratory income and nursing income are the top 3 medical service items that cause the structural change of inpatient income,and the 3 cumulative contribution rates are 72.94%.(3)the proportion of Chinese medicine service income in medical income is only about 3.2%,and the income of Chinese type is less than 20%.Western medicine technical services in treatment income and surgical income increased,but the proportion of its income is less than 10%.The income of the operation did not increase to the level of measurement.(4)the rate of business income is negative growth after the reform,and the balance of the current period is just more than 100 yuan.In the case of increasing business cost,the government subsidies accounted for only about 4.6%of the total hospital income.Conclusion and suggestions:At present,the hospital income structure has been optimized gradually,the reform of the compensation mechanism has been achieved,and the proportion of the case hospital’s drugs has decreased obviously,but the medical income still has a great dependence on the drug income;the case hospital doesn’t have obvious effect on the traditional Chinese medicine characteristics,the proportion of traditional Chinese medicine service items are relatively low,adjusted the medical service price hasn’t compensate the drug losses.The expenditure of business income continues rising after the reform,but the government’s financial subsidy to the case hospital is insufficient and the financial subsidies need to be strengthened.(1)The proportion of drugs needs to be further reduced,focusing on the medical services that cause large changes in income structure.(2)Strengthen the characteristics of Chinese medicine,improve the level of technical services of Chinese medicine,and strive to expand other services to increase hospital revenue channels.(3)Continue to promote fine management of hospitals,enhance the ability of throttling,reduce unnecessary expenses,reduce costs reasonably,and achieve effective cost control.(4)To continuously establish and improve the service price compensation for traditional Chinese medicine hospital,gradually strengthen the diagnosis and treatment projects of traditional Chinese medicine,and appropriately adjust and improve the treatment and diagnosis price of medical service of traditional Chinese medicine,in order to reflect the value of the labor service of medical personnel of traditional Chinese medicine.(5)To clarify the leading role of government compensation to traditional Chinese medicine hospitals,to design reasonable government financial compensation and compensation path,to improve the existing compensation mechanism for traditional Chinese medicine hospital,and to increase financial compensation. |
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