ABSTRACT
Based on the basic data of China's total health expenditure from 2003 to 2015, this paper compares and analyze the structural characteristics of total health expenditure financing and the per capita disposable income before and after the new health care reform, in order to understand the overall level of total health expenditure financing before and after the new health care reform, whether the financing structural changes is reasonable and the overall trend is sustainability, and the relationship of the changes between per capita disposable income and health expenditure.The study found that, 1) although the growth rate of total health expenditure in China has declined after the new health care reform, the growth rate of personal health expenditure is still on the rise;2) the growth rate of government health insurance expenditure is limited to the substitution of personal health expenditure, and the growth rate of per capita personal health expenditure is still higher than the growth rate of urban and rural residents' per capita income;3) the problem of residents' serious burden of medical treatment is still very prominent.Based on the above problems, this paper accordingly proposes to speed up the reform of public hospitals, strengthen the construction of medical insurance fund specialization, and improve the ability of medical insurance fund to control costs, etc.
ABSTRACT
OBJECTIVE:To provide reference for developing zero-profit drug policy and compensation mechanism better in ur-ban public hospitals. METHODS:Taking a public hospital in a city as an example,effects of zero-profit drug policy on hospitals, patients,health insurance fund and single diseases with different drug proportions [cataract (2.94%) vs. chronic renal failure (38.77%)] were investigated by analyzing the canceled drug addition costs and adjusted medical service price data after developing zero-profit drug policy. RESULTS:After developing zero-profit drug policy,the overall compensation rate in the public hospital was 95.20%. The overall burden of urban patients was reduced,average burden cost was decreased 197.73 yuan every time;while the overall burden of urban and rural residents had increased,average burden cost was increased 17.39 yuan every time;and the overall burden of all patients had decreased. Health insurance fund had decreased,in which,the urban workers were decreased 151185500 yuan,and urban and rural residents were increased 4550400 yuan. In medical insurance for urban workers and health insurance for urban and rural residents,hospital increased by 7.00% and 8.99% in income in the treatment of cataract,the medical insurance fund increased by 12.07% and 13.67%,and patients'burden increased by 0.58% and 3.43%,respectively. For chronic renal failure,hospital income increased by 3.23% and 3.93%,medical insurance fund decreased by 3.19% and 3.96%,and pa-tients'burden decreased by 4.27% and 3.63%,respectively. CONCLUSIONS:Zero-profit drug policy is the ideal measure for get-ting rid of"drug-maintaining-medicine". When developing the policy,it should be combined with actual situation and different dis-eases to explore adjustment of medical service prices,reasonable financial compensation models and medical insurance payment mechanism.
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OBJECTIVE:To provide reference for clinical prevention and treatment of ceftizoxime-induced hemolytic anemia by investigating the situation of ceftizoxime-induced hemolytic anemia. METHODS:Using Chinese and English“ceftizoxime”“he-molysis”and other words as key words,related literatures during 1986-2015 were retrieved from CNKI,Wanfang database and PubMed database. Those literatures were analyzed statistically in respects of general information,clinical drug use and manifesta-tion,occurrence time and outcome,etc. The mechanisms of hemolytic anemia were analyzed to put forward prevention and treat-ment measures. RESULTS & CONCLUSIONS:A total of 11 literatures were retrieved,including 4 foreign literatures and 7 domes-tic ones. There were 15 cases in total,including 5 foreign cases and 10 domestic cases. According to the patient’s age,there were 7 cases of infants,4 cases of the elderly,3 cases of middle-aged people and 1 case of youth. The hemolytic anemia often occurred on the 2-7 day(8 cases). Most of the patients were improved after treatment,but there were 3 patients who died. The mechanism of hemolytic anemia mainly included the production of immune complex and non-immunologic protein adsorption. It is suggested to investigate allergic reaction history,pay attention to sensitization test on skin,select suitable drug dosage and avoid drug combina-tion. The patient’s medications should be monitored closely. Once hemolytic anemia occurs,it should be immediately stop using the drug and take appropriate measures as hormone treatment,comprehensive treatment,blood transfusion treatment,to avoid en-dangering the life safety of patients.
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OBJECTIVE:To provide reference for rational use of analgesic drugs for advanced cancer,moderate to severe pain. METHODS:The data of narcotic drugs and first type psychotropic drugs were collected from hospital information system of a third grade class A hospital during 2012-2014,and then analyzed in respects of amount,consumption sum and DDDs,etc. RE-SULTS:The amount of narcotic drugs and first type psychotropic drugs kept stable basically,and the consumption sum of them during 2012-2014 was 1 566 289.92 yuan,1 525 220.23 yuan and 1 531 277.44 yuan. The consumption sum of Morphine hydrochlo-ride tablet increased the fastest,increasing by 89.78% in 2013 and 142.81% in 2014,compared with the year before;those of other drugs had negative growth rate. DDDs of Morphine hydrochloride sustained-release tablets were the highest among all the narcotics and first type psychotropic drugs and increased year by year,increasing from 26 848.00 in 2012 to 47 158.00 in 2014. CONCLU-SIONS:The use of narcotic drugs and first type psychotropic drugs conform to the specifications,but they still need strict supervi-sion to promote safe and effective use of them in the clinic.
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OBJECTIVE: To analyze the effects of Essential Drug Systems on primary medical institutions. METHODS: According to related regulations for primary medical institutions in Suggestions on the Implementation of National Essential Drug Systems, the problems on the implementation of Essential Drug System were analyzed and discussed. RESULTS: The concepts of essential drug were not promulgated widely. Present essential drug supply guarantee system had limitation and essential drug distribution was kept at low level. Essential drug quality guarantee system had not been established and compensation supporting measures weren’t carried out completely. Above problems affected the implementation of Essential drug system in primary medical institutions. CONCLUSIONS: Government should set up multi-channel compensation mechanism and comprehensive evaluation mechanism for drug bidding, and select distribution enterprise rationally. Government also should increase the proportion of medical cost reimbursement in primary medical institution and improve the propaganda of National Essential Drug System.