Analysis On The Current Situation And Causes Of Medical Expenses In Crease In Public Hospitals In Guizhou Province From 2014 To 2017

Objective: Analyzes the causes and influencing factors of the rapid increase of medical expenses in public hospitals of secondary and above in Guizhou Province,identify changes in demand for medical services,changes in patient flow,price and cost of medical services,Explores how to control the cost of medical services in the new situation,how to deal with the growing demand for medical services and patients to large hospitals.Understand the implementation effects of policies such as zero-margin sales of drugs,and analyze emerging issues that may arise during policy implementation.Based on the actual situation in Guizhou Province,it provides a basis for formulating relevant policies for reasonable control of medical expenses.Methods: Data from 185 secondary and above public hospitals in 9 cities(states)of Guizhou Province,data that meet the test of normality and homogeneity of variance are processed using t test or analysis of variance.By comparing the growth of total medical income of 185 public hospitals in Guizhou Province from 2014 to 2017,calculate growth rate,analysis of differences in hospital cost increases across regions and levels.Calculate the growth rate of various medical business costs from 2014 to 2015,assess the overall change and control effect of sub-surveillance and inpatient medical expenses.Analyze changes in outpatient and inpatient visits and calculate the contribution of incremental patients to medical income.Compare the primary hospitals in the Statistical Yearbook of Guizhou Province from 2014 to 2017 and judging the patient's visits and the flow of patients in the public hospitals of secondary and above public hospitals.Find out why the medical expenses are growing rapidly.Results: In 2015,2016,and the first 11 months of 2017,the medical expenses of 185 public hospitals in Guizhou Province reached 29 billion yuan,33.1 billion yuan,and 34.8 billion yuan respectively,the growth rates were 12.00%,14.38%,and 16.27%,respectively,and the differences were statistically significant(P<0.01).Public hospital outpatient and inpatient drug,inspection,laboratory and health materials income is growing,in 2015 and 2016,outpatient drug revenue increased by 10.20% and 6.31% respectively,the income of outpatient examination increased by 14.92% and 16.57% respectively,the outpatient test increased by 23.92% and 29.52% respectively,the income of outpatient health materials increased by 47.95% and 42.57%,respectively,and the difference was statistically significant(P<0.01).The medical business costs increased by 15.65% and 17.36% from 2014 to 2015 and 2015 to 2016 respectively,the expenditure on personnel increased by 23.79% and 24.62% respectively;the growth rate of sanitary consumables was 20.71% and 21.59% respectively;the cost of medicines increased by 5.59% and 15.93%,respectively,and the difference was statistically significant(P<0.01).The average outpatient medical expenses increased by about 6.48% from 2014 to 2015,but there was almost no change from 2015 to 2016.The test results showed that the difference was not statistically significant.The average hospitalization medical expenses showed an increasing trend from 2014 to 2016,with an increase of 2.58% and 3.41%,respectively.The difference was statistically significant,but the increase was much lower than the increase in hospitalization income.From 2014 to 2016,the total number of outpatients in 185 public hospitals showed an increasing trend,in 2015 and 2016,it increased by 2,365,700 and 413,100,respectively,with an increase of 8.63% and 13.87%.The total number of medical treatments in the province's medical institutions has been growing for 4 years,with an average annual growth rate of 5.77%,In 2015,2016 and 2017,the total number of hospitalizations in the grassroots and county-level and above medical institutions in the province increased by 0.54%,3.54% and 10.08% respectively.The number of hospitalizations in township hospitals decreased by 20.06% and 6.11% in 2015 and 2016 respectively,almost unchanged in 2017.Outpatient and inpatient drug costs accounted for a downward trend,the proportion of outpatient drug expenses decreased by 4.73% and 6.82%,respectively,and the proportion of hospitalized drugs decreased by 3.40% and 7.68% respectively.The increase in patients' income for the whole year of 2015 increased by 2.133 billion yuan(8.24%),after deducting the medical income brought by the incremental patient,The actual medical income of 185 hospitals only increased by 3.76%.Incremental patients brought an increase of 4.172 billion yuan(12.0%)for 2016,and the actual increase in income after deducting incremental patients was only 2.4%.After deducting the medical income from incremental patients in 2017,the total actual medical income of 185 hospitals increased by only 1.28% as of November 2017.Conclusion: Since the implementation of China's new round of health care reform policy,the average medical expenses of 185 public hospitals of secondary and above in Guizhou Province were effectively controlled,but because of the growing number of people,in addition,factors such as medical costs have led to a rapid increase in medical expenses.The health decision-making department should fully consider the changes in medical service demand in the process of formulating the control policy,preventing the risk of hospital policy losses and rapid increases in costs to health care funds.Strengthening the reform of grassroots medical institutions and performance pay,improve the service capacity of primary medical institutions,ensure that the grassroots can stay in the patient,changing unreasonable patient flow.Promote the construction of medical associations and implementation of graded diagnosis and treatment system,grasping the big trend of big data development,utilizing telemedicine service platform,let the hospital better serve patients,solve the problem of insufficient and unbalanced development of medical resources in the region.