ABSTRACT
Objective:To obtain the health production efficiency performance and its changing trend of China's health system in recent years by adopting international comparison,and to provide policy recommendations to improve health production efficiency.Methods:It described the relative efficiency of health system in China by reporting the international ranking of health inputs and outputs indicators.It employed total health expenditure per capita as input indicator and health outcomes as output indicators to construct frontier health production function,China's health production function and marginal health production function based on data envelopment analysis and production function method.Results:In the past decade,compared to efficient countries with similar health development level,the efficiency performance of China's health system was between 65％ and 73％.With the increasing trend of health investment,China's marginal health output had been declined and tended to be gentle.Conclusion:The current health production efficiency in China was relatively high.However,how to improve the efficiency and marginal health output was the focus of future health system reform under the background of rapid growth of total health expenditure.
ABSTRACT
Objective:To evaluate the impact and analyze the mechanism of separating drug sales from medical services reform on the total medical expenditure containment of outpatient services in Beijing. Methods:The monitoring data and historical data from 89 third-level,78 second-level public hospitals,and 206 primary health institutions and community health service agencies,which participated in the reform,were analysed to estimate the impacts on outpa-tient service utilization and service price. The analysis was based on the data of the first and second quarters of 2016 outpatient and emergency department fee changes,and analysis of service utilization and service price factors on the im-pact of changes in outpatient and emergency services mechanism. Results:The total outpatients'expenditure in Beijing in the second quarter of 2017 was 17.38 billion yuan,representing a slight decrease of 1.14% than the expenditure in 2016. The growth rate reduced by 2.46%. Expenditure in third-level and second-level hospitals decreased by 2.82% and 3.02%,respectively,with reductions in growth rates of 4.06% and 3.74% respectively. Expenditure in primary institutions increased by 17.09%. The increase rate in the second quarter of 2017 was 26.28%,representing a remark-able increase compared to the rate in 2016(15.84%). The contribution from the medical institution service prices and service utilization to the change of outpatient and emergency medical expenditure containment was 6.98% and -7. 65%,respectively. For third-level hospitals,the contribution was 10.37% and -12.00%,respectively;second-level hospitals were 0.72% and -3.35%,respectively;and the primary health institutions was 6.08% and 9.57%. Con-clusions:Beijing's comprehensive reform of separating drug sales from medical services reform has effectively controlled the rising medical expenditure of outpatient services,mainly by adjusting outpatients service utilization between differ-ent level healthcare institutions.
ABSTRACT
Objective To compare the medical expenditure and its trend for diabetes mellitus and non-diabetes mellitus and to assess the direct economic burden of diabetes for individuals and families.Methods Using data from the China Health and Nutrition Survey (CHNS),propensity scores matching (PSM) was used to match diabetes mellitus and non-diabetes mellitus according to the related characteristic variables.Data from 679 pairs of objects was then compared.Results From 2000 to 2009,gaps of annual medical expenditure from diabetes mellitus and non-diabetes mellitus showed an increase,from 3361.93 to 6608.48 Yuan,with the ratios of medical expenditure about 4 times.The ratios of personal economic burden and family economic burden had an increase of about 4-5 times.Conclusion Compared with non-diabetes mellitus,the annual medical expenses was significantly higher among patients with diabetes mellitus.The absolute cost appeared a dramatic increase,along with the personal and familiar economic burden.