An Empirical Study On The Impact Of Payment Reform On Public County-level Hospitals

Objective: This paper analyzes the changes in hospitalization costs,average length of stay,medical staff satisfaction,and hospital efficiency of Minhou County Hospital during 2011-2016,then explores the impact of payment mode reform on the operation of public hospitals and figure out the mechanism of the impact of payment mode reform on the operation of public hospitals,so as to provide corresponding countermeasures and suggestions for accelerating the reform of county-level public hospitals.Methods: Analyzes the diseases groups coverage,the effect of medical expenses and its composition after the reform of payment mode based on the NRCMS monitoring data from 2011 to 2016 offered by Fuzhou Health and Family Planning Commission;using questionnaire to explore the changes of satisfaction of medical staff after reform of payment mode;and data envelopment analysis was used to analyze the changes in the operating efficiency of public hospitals and to explore the impact of payment mode reform on hospital operations.Results:(1)The number of diseases covered by reforms in payment mode has increased from 12 to 25;and the coverage rate has increased from 33% in 2013 to 67% in 2016;(2)The increase rate of average hospitalization expenses was lower than that of non-reformed hospitals,and the rate of growth of disease coverage covered by the reform was lower than that of uncovered diseases;the composition of the costs was also more reasonable;(3)Average hospital stay decreased after reform of payment method;(4)Compared with 2015,the degree of satisfaction of medical staff has increased in 2016,mainly in terms of work environment,income and incentive mechanisms,but satisfaction with work risks has not changed;(5)The efficiency of the hospital has been improved.Conclusion: To some extent,payment mode reform can promote the reform of public hospitals,but the effect is reflected in the need for comprehensive reform in other areas.It is recommended to speed up the integration of medical insurance management system,expand the coverage of payment mode reform,and promote the reform of the internal operating mechanism of the hospital.