| BackgroundSince the start of new medical reform in 2009,mechanism reform of medical service pricing and compensation in public hospital has gradually become the core mission,for which the government has successively carried out new policies and set experiments across the country.It the beginning of 2012,China has accelerated the medicine price reform of public hospitals.According to the document,which was jointly issued in July 2016 by four departments including the National Development and Reform Commission,about "advance the reform of medical service price",China will comprehensively advance the reform on the basic of "total amount control,structural adjustment,rise and fall,gradually in place".At present,some provinces and cities such as Beijing,Shanghai,Jiangsu,Anhui etc.have taken the leading role in medical service price reform,while only Shenzhen,Zhongshan,Dongguan and Zhuhai have carried out pilot work in Guangdong Province.Although Guangdong Province has made some positive achievements in deepening the medical service price reform,it still needs to straighten out the medical service price,improve the management methods and further standardize the price behavior.Therefore,by combing the pricing theory and method comprehensively,learning advanced practice from foreign countries and reform experience from domestic provinces and cities,according to the national medical service price documents,based on the collection and analysis of the economic basic data of the provinces,subordinates and military hospitals in Guangdong Province,this paper studies the principle,scope,range of adjusting medical service price,constructs the model of medical service price adjustments,calculates and analyzes the medical service price adjustment scheme empirically to put forward the corresponding policy recommendations and provide decision support to promote the reform of medical service price in Guangdong province.MethodsThe research methods adopted in this subject are including:literature consultation,questionnaire survey,descriptive statistics analysis,comparative analysis,expert consultation,empirical analysis.Conclusion1.The scheme of medical service price adjustment:based on the calculation of total price adjustment,according to the price theory,price policy,schemes of price adjustment in different provinces and cities,the principle and range on medical service price adjustment scheme,the paper has designed two sets of programs,plan A and plan B,including A-1,A-2,A-3,B-1,B-2,and B-3.Take A-1 as an example:(1)cancel 80%of drugs and consumables addition;(2)reduce 8%of the prices of medical image,nuclear medicine,medical laboratory(except for clinical microbiology)on the existing basis;(3)increase the prices of integrated medical service by 34%on the existing basis;(4)increase 30%of the prices of clinical treatment,surgical treatment,physical therapy and rehabilitation,as well as traditional Chinese medicine and national medical treatment on the existing basic;(5)increase the prices of pathological examination(except for molecular pathology diagnostic technology)by 9%on the existing basis;(6)do not adjust the price of ultrasonography,radiotherapy,blood type and blood matching,vascular interventional treatment project.2.The price adjustment scheme of medical.service is reasonable and practicable.The empirical results from ten hospitals show that the mean values of"medical service price adjustment ratio" in A-1,A-2,A-3,B-1,B-2,B-3 are 100.71%,100.72%,100.66%,100.78%,100.91%,100.94%.All of them are within the reasonable range between 95%to 105%.Suggestion1.Adjust price in one step;2.Use mode of Shanghai and Jiangsu;3.Medical service prices should be higher than the province which has reformed;4.Establish dynamic price evaluation and price adjustment mechanism;5.Implement national price standard for medical services(2012 Edition);6.Promote the circulation area reform of drugs and consumables;7.Establishment warning mechanisms and contingency fund. |
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