Research On The Compensation Mechanism Of Mental Health Hospital Under The Background Of Zero Profit Drug Policy

Objective: With the implementation of the policy of "zero drug additions",the compensation of public hospitals in China has gradually changed from three channels of medical service charge,drug additions income and government subsidy to two channels of medical service charge and government subsidy.China’s financial investment in public hospitals has been at a low level of about10% for a long time,and the price of medical fees in public hospitals has deviated from the cost for a long time.In this context,if there is no effective and timely financial compensation policy,the economic operation of public hospitals will inevitably face tremendous pressure,thus affecting hospitals.Normal operation and development can induce excessive medical treatment,which is not conducive to the return of public welfare in public hospitals.As a special group of public hospitals in China,psychiatric hospitals are responsible for the prevention of mental illness,handling crisis intervention,maintaining social stability and other public health services.At the same time,due to the particularity of service objects,the profitability is weaker.If the compensation is insufficient or improper,it is more likely to cause new problems and affect the reform effect.Methods: This paper studies the current situation of the compensation mechanism of public hospitals in China from three aspects of compensation subject,compensation method and compensation scale,and focuses on the effectiveness and problems of the existing two channels of compensation after the "3-1" compensation channel of public hospitals.This study takes a city level top three mental health hospital(hereinafter referred to as "hospital a")as an example,and further reveals and discusses the current situation of the development of public hospitals,especially mental health hospitals,and the existing problems in the compensation process by analyzing the changes of hospital economic data before and after the implementation of "drug zero plus" and the new problems in the operation process of hospitals after the implementation of the policy In order to provide suggestions and reference for the higher authorities to further study,formulate and improve the compensation policy of public hospitals.Research methods: through combing the history of the public hospital financial compensation system,using theoretical analysis,data analysis,combined with hospital a case analysis,cost accounting and other methods to carry out research,and try to explore the existing problems in the compensation mechanism of public hospitals,especially the problems in the compensation process and daily operation of psychiatric hospitals.And put forward corresponding suggestions to improve the compensation mechanism for the problems found,in order to improve the compensation mechanism of public hospitals and further improve the compensation effect of psychiatric hospitals.Result: first of all,by analyzing the relationship between the trend of health data changes before and after the new medical reform,medical and health policies,and financial compensation policies,we know that a stable public financing channel is the economic basis to ensure the operation and long-term development of public hospitals.On this basis,it is suggested to steadily increase the financial investment in the public health system,including the investment in public hospitals and medical insurance funds.Secondly,this paper analyzes the current situation of compensation in public hospitals from three aspects: the main body of compensation,the way of compensation and the scale of compensation.Through the case analysis of hospital a,including data analysis,interviews and telephone interviews with eight district level mental health institutions,this paper summarizes the current income,cost structure characteristics and compensation status of mental health specialized hospitals,and puts forward some suggestions on financial compensation policies to reflect differences.In addition,through literature search,policy analysis and a hospital case analysis,this paper verifies that rationalizing the medical service charge price is an important and effective compensation method after canceling the drug mark up in public hospitals.Help the hospital to realize income translation after the implementation of zero drug markup.However,through the cost accounting of medical service projects,it is found that the pricing of many service charging projects still deviates from the cost.It can be seen that the government department lacks the cost data of public hospitals,which makes the compensation tool of charging price inadequate.It is suggested to carry out standardized project cost accounting led by the government,and on this basis,promote the improvement of medical service pricing system,guide Price dynamic adjustment.Finally,through literature research,data analysis and case analysis,this paper finds that there are some problems in the compensation mechanism of public hospitals,such as unclear compensation channels,unclear boundaries of compensation objects and insufficient incentive benefits of compensation mechanism.It is suggested to establish a compensation mechanism of "medical service cost compensation is realized by rationalizing the medical price,hospital necessary construction and public service cost compensation is realized by financial subsidies,hospital talent introduction and discipline development are realized by providing value-added services and balance of revenue and expenditure",and embed corresponding financial funds,hospital and personnel’s Performance appraisal system.Conclusion :At present,the direction of China’s medical reform is to change the situation of "medical care based on drugs" in public hospitals,to "medical care based on technology",to eliminate drug markup,rationalize service prices,and optimize compensation mechanism,so as to alleviate the social problems of "difficult and expensive medical treatment".But it needs to have corresponding compensation mechanism,corresponding assessment and evaluation mechanism,cost accounting mechanism,personnel performance mechanism and medical insurance fund payment mechanism to cooperate with each other.