Study On The Model And Simulation Of Reimbursement Schemes For Public Hospitals In China Based On System Dynamics

In China, public hospitals play a critical role in improving people’s health, and to some degree can enhance the economic development of the country. The new healthcare reform clearly put forward medical separation, reform the mechanism of drug income compensate the medical services revenue, shorten the compensation channels for public hospitals gradually from medical services charges, drug additional income and government grants three channels to medical services charges and government grants two channels. Therefore, under this situation, how to reform the public hospital and build the scientific and appropriate compensation mechanism are focal point of the public hospital reform. This paper tightly around the new medical reform, using the theories and methods of system dynamics, adopted hospital financial system started in 2012 for the classification of income and expenses to study the system government compensation, market compensation (medical services income and drug income) and other social compensation, provide policy advice to the public hospital compensation mechanism.First of all, this paper reviews the history of reimbursement schemes in public hospitals, application of system dynamics in the domestic medical service management, and concludes the related conception and character in the theory. Next we collect data from the Chinese Health Statistics Yearbook and analysis the revenue and expenditure of public hospitals, summarizes the status quo of public hospitals:lack of government financial subsidies, the medical services’ price distortions, medicines compensation overrepresented as well as the imperfect reimbursement channels. Then, according to the income and expenditure of public hospitals, build our public hospital system dynamics model of the compensation mechanism by using of system dynamics approach. Furthermore, simulate the model by using of data for Health Statistics Yearbook, and finding the problems and solutions of the compensation mechanism in public hospitals. Finally, providing a viable reform program for the government.Conclusions of the paper are as follows:firstly, for the three-level public hospital, the growth rate of government’s fiscal revenue is 20 percent, the growth rate of price of medical services is 11 percent, the other income increase 5,000,000 yuan under a further growth rate of 35%; secondly, for the second-level public hospital, the growth rate of government’s fiscal revenue is 18 percent, the growth rate of price of medical services is 9 percent, the other income increase 1,000,000 yuan under a further growth rate of 35%; thirdly, for the stair public hospital, the growth rate of government’s fiscal revenue is30 percent, the growth rate of price of medical services is 10.5 percent, the other income increase 300,000 yuan under a further growth rate of 35%. Under this situation, our public hospitals can ensure self-financing. Accordingly, we propose the policy recommendations as follows:increase government compensation efforts, improve medical service price formation mechanism, expand channels of public hospital compensation and so on. In the new health care reform situation, this study has important theoretical significance and reference value for public hospitals.