Analysis of Influencing Factors of Medical Service Price Dynamic Adjustment Based on the DEMATEL / 中国卫生经济

Objective:To provide suggestions for figuring out the price formation mechanism of medical services by studing the in-fluencing factors of the price dynamic adjustment and identify the relationship among the factors.Methods:The price policies and published literature were searched for preliminarily screening out the influencing factors of the prices dynamic adjustment.The influ-encing factors and their relationship were analyzed by decision-making trial and evaluation laboratory and expert consultation method.Results:A total of 9 cause factors and 6 result factors were selected.In the cause reasons,the change of service factor cost,the de-gree of leadership support and the price relationship of medical service were in the top three;among the outcome factors,the level of medical burden of the masses,patients'satisfaction with price and actual financial compensation ability were more susceptible to other factors.Conclusion:Promoting the reform of medical service prices dynamic adjustment by reasonably calculating the cost of medical service factors,increasing the price adjustment attention of leaders,straightening out the price relationship of medical services,paying full attention to the level of medical burden of the masses and patients'satisfaction with price and improving the substantial financial compensation capacity of institutions for policy losses.

Practice of clinical pathway management based on clinical decision support system / 中华医院管理杂志

Clinical pathway management is an important part of public hospital reform, providing great significance for regulating medical behavior, improving medical quality, and controlling unreasonable medical expenses. In December 2020, a tertiary hospital conducted clinical pathway management practices based on clinical decision support systems. Through segmented design of clinical pathways, dynamic adjustment of pathway execution process, quality control throughout the entire process, and performance evaluation and continuous improvement, the management level of clinical pathways was comprehensively improved. After one year of practice, the hospital clinical pathway management based on clinical decision support systems had achieved good results. The average days of stay of patients decreased from 6.58 d in 2020 to 6.32 d in 2021, the proportion of admitted patients to discharged patients increased from 63.10% to 67.47%, the admission rate increased from 88.32% to 90.43%, and the variation rate decreased from 20.03% to 15.00%. This management practice provided a reference for public hospitals in China to improve the quality and efficiency of clinical pathway management.

Research on the Construction of Trigger Index System for Dynamic Adjustment of Medical Service Price in Tangshan / 中国卫生经济

Objective:To construct a set of weighted trigger index system for dynamic adjustment of medical service price,so as to provide references and basis for price adjustment of complex medical service projects in Tangshan.Methods:The Delphi expert consultation method was used to demonstrate and determine the index system,and the difference comparison method and product method were used to determine the weight coefficient for each index.Results:The trigger index system of dynamic adjustment of medical service price including 4 first-level indicators,10 second-level indicators and 29 third-level indicators,and the weight coefficient of each indicator was given.Conclusion:The trigger index system of dynamic adjustment of medical service price in Tangshan has high scientificity and reliability,which is helpful for Tangshan to establish a sensitive and moderate price dynamic adjustment mechanism.Considering the affordability of all parties in the price adjustment of medical services in Tangshan,it is conducive to strengthening the total price control and structural adjustment of medical services in Tangshan.

Establishment of an effectiveness evaluation index system of dynamic medical service pricing adjustment / 中华医院管理杂志

Objective To construct an index system for evaluating the effectiveness of dynamic pricing adjustment of medical services,for the purpose of providing a set of evaluation tools for price regulatory authorities to evaluate the effectiveness of pricing adjustment of medical services,to keep track of pricing trends,to implement dynamic monitoring and to guide decision-making.Methods Oriented to public hospitals in Guangdong province,literature analysis and Delphi method were used to construct the index system for evaluating the effectiveness of dynamic adjustment of medical service price.Descriptive analysis,consistency test and index importance evaluation were applied to statistical analysis.Results Thirty-two experts evaluated the importance of 41 alternative indicators.The index system for evaluating the effectiveness of dynamic adjustment of medical service price was finally constructed,including six structural indicators,six process indicators and six result indicators.Conclusions Experts are representative,authoritative and well-coordinated.The consultation results are reliable.The evaluation index system has high reliability and validity,and can be used to objectively evaluate the dynamic adjustment effect of medical service price.

Establishment of an effectiveness evaluation index system of dynamic medical service pricing adjustment / 中华医院管理杂志

Objective@#To construct an index system for evaluating the effectiveness of dynamic pricing adjustment of medical services, for the purpose of providing a set of evaluation tools for price regulatory authorities to evaluate the effectiveness of pricing adjustment of medical services, to keep track of pricing trends, to implement dynamic monitoring and to guide decision-making.@*Methods@#Oriented to public hospitals in Guangdong province, literature analysis and Delphi method were used to construct the index system for evaluating the effectiveness of dynamic adjustment of medical service price. Descriptive analysis, consistency test and index importance evaluation were applied to statistical analysis.@*Results@#Thirty-two experts evaluated the importance of 41 alternative indicators. The index system for evaluating the effectiveness of dynamic adjustment of medical service price was finally constructed, including six structural indicators, six process indicators and six result indicators.@*Conclusions@#Experts are representative, authoritative and well-coordinated. The consultation results are reliable. The evaluation index system has high reliability and validity, and can be used to objectively evaluate the dynamic adjustment effect of medical service price.

Research on Medical Service Price Dynamic Adjustment Strategy in the View of Tripartite / 中国卫生经济

There ass an urgent call for the dynamic medical service price-adjustment mechanism with the fully launched Zero Markup policy,however it was lacking of one unified coordination mechanism between departments.It analyzed the responsibilities and challenges of four departments(Health,Pricing,Health Insurance and Finance Department).Also,one theoretical model has been established for analyzing the impacts on the four departments by the scope of pricing-adjustment.By witnessed the evidences on the price-adjustment,it highly recommended that the strategy for price-adjustment should go with high frequency but in a minor change.Meanwhile,it also proposed that to build one well-coordinated mechanism,introduce third parties to involve,and establish one simulation system for price-adjustment to push forward the progress of dynamic price-adjustment mechanism.

The dynamic adjustment mechanism of medical service price in the United States and its implications for China / 中国卫生政策研究

The establishment of a scientific and reasonable medical service price dynamic adjustment mechanism is the focus of the current reform of public hospitals in China.This paper analyzed the medical service price reform history in the United States, the price dynamic adjustment of the main body and its process, as well as the development trend of medical service price reform.At the same time, the existing problems of medical service price adjustment in China were briefly analyzed, and put forward 1) the establishment of multi-participant dynamic adjustment model;2) the establishment of the medical service standard value system, strengthening Medicare payment standard construction;3) and gradually changing the current fee-for-service payment system and establishing DRGs and performance based payment mechanism and other policy recommendations.