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.

Policy Evolution,Implementation Dilemma and Breakthrough on Medical Service Price Items Normative Management and Its Enlightenment / 中国卫生经济

It reviewed the policies related to the standardized management of medical service price items,analyzed the current difficulties in the implementation of medical service price regulations:the technical specifications of national medical service price item are heavy and cannot be dynamically adjusted with technological innovation;provincial level item access control is not strict,and the elements of the same price item are not completely unified,affecting the horizontal comparison.The policy suggestions to speed up the improvement of the medical service price item specifications include:medical services that are allowed to be applied and have clear technical specifications are accepted as the scope of new price item declaration;promote the separation of technology and consumption,except for consumables and reagents,which are priced separately according to service items+special consum-ables;priority should be given to responding to the legitimate demand for medical technology improvement innovations through cur-rent price item compatibility;contrast technical specifications and item guidelines,integrating current price items,improving item standardization and compatibility;complete the innovation and economic evaluation of the newly declared item price,check the quality,and reasonably determine the increment.

Practice Progress and Enlightenment of Promoting Medical Service Price Reform in the Pilot Cities / 中国卫生经济

Based on the relevant policy documents of deepening medical service price reform in the pilot cities,combined with research and interviews,it analyzes the practical progress of measuring the total amount of medical service price adjustments in the pilot cities and the overall distribution of the total amount,the classification of items for pricing and dynamic adjustment,and the monitoring and assessment.It is suggested to explore the construction of a concise indicator system and a practical measurement method,consider the sustainability of the total price adjustment of medical services,and continue to optimize and improve the price adjustment mechanism of medical service price items.

Calculation method and empirical analysis of the total amount of price adjustment in medical service price reform / 中华医院管理杂志

In order to further promote the reform of medical service price and strengthen the macro management of medical service price, the author constructed a calculation method for price adjustment space of medical service. This study was centered on two parameters of the historical base and the growth coefficient, to calculate the total amountof price adjustment. The historical base used the total revenue of medical services in the region from the previous year, and the growth coefficient was measured by two methods, the comprehensive indicator method and the consumer price index (CPI) reference method.Taking Suzhou, a national pilot city, as an example, the historical base in 2022 was 18 754 million yuan. By using the comprehensive indicator method, the annual growth coefficient was calculated to be 2.38%, and adjustment space of medical service price was 446.35 million yuan; According to the CPI reference method, the growth coefficient of Suzhou was 2.10%, and adjustment space of medical service price was 393.83 million yuan.The two methods for calculating the total amount each have their own advantages and disadvantages, and need to be further optimized and improved by drawing on the practical experience of reform in each pilot city.

Construction of the evaluation index system on the mechanism of medical service price reform / 中华医院管理杂志

Objective:To design a set of evaluation index system for the medical service price reform mechanism, so as to provide reference for the evaluation of deepening the medical service price reform mechanism.Methods:On the basis of searching literature of medical service prices reformfrom August 2021 to March 2023, policy logic analysis and expert consultation were used to construct evaluation indexes for the medical service price reform mechanism, set evaluation index thresholds, and assign scores to index thresholds in different grades.Results:The evaluationindex system of medical service price reform mechanism included 5 level-1 indexes, 12 level-2 indexes and 35 level-3 indexes. After scoring, the scores of 5 level-1 indexes were 12, 24, 35, 21, and 8, respectively.Based on the percentile scoring method, the evaluation criteria were categorized into five grades: premium, excellent, good, average and failure.Conclusions:This study constructed a set of evaluation index system for the mechanism of medical service price reform, which had strong scientific and operability. However, due to the fact that medical service price reform in the new era is still in its initial stage, the index system need to be further optimized drawing on the practical experience of reforms in pilot cities.

Status, problems and development advices on medical service price management / 中华医院管理杂志

The reform of medical service prices in China has been launched, and the reasonable pricing and management of medical technology services are of great significance for improving patient well-being and advancing the reform of our medical system. The author provided a detailed review of the policy evolution, current management status, and main issues of medical service price management in China since 2000. The medical service price management policies in China since 2000 were divided into four evolutionary stages: initial exploration of decentralization, substantial development, continuous advancement, and deep promotion. The author also described the formation mechanism and pricing methods of international medical service prices, and compared the similarities and differences in medical service price management at home and abroad. Some suggestions were put forward for improving the macro reform of medical service price management in China.

Study on Policy Diffusion Characteristics of Medical Service Price in China / 中国卫生经济

Objective:The price of medical services is related to the vital interests of the people.It aims to explore the policy dif-fusion characteristics of medical service prices in China,and promote the reform of medical service prices.Methods:Based on the theory of policy diffusion,it conducts text measurement and content analysis on 440 central and provincial policies in China from 2000 to 2022.The diffusion of medical service price policies is analyzed from three dimensions:time,space,and content.Keyword temporal analysis was used to deeply explain the diffusion mode and mechanism of medical service price policies.Results:In terms of time dimension,the diffusion of medical service pricing policies in China generally follows a"ladder shaped"trajectory of"slow-fast-slow-fast alternation"in speed;in terms of spatial dimension,there are differences in the enthusiasm of policy adoption among provincial governments in China,and policy diffusion has a proximity effect;in terms of content dimension,China's medical service pricing policy focuses on three aspects:institutional norms,specific regulations,and external environment.Conclusion:The price of medical services in China has the characteristics of a top-down hierarchical diffusion model in policy diffusion,as well as a parallel diffusion model between departments and regions at the same level.

Pricing Methods and Thoughts for Medical Service Item under the Background of Deepening Medical Service Price Re-form / 中国卫生经济

Medical service price reflects the value and the financial compensation for medical services.The medical service price reform plays an important role in optimizing the allocation of medical resources and transforming the operating mechanism of public hospitals.The pricing of medical services should take many factors into consideration such as the characteristics of medical service,service markets,service costs,supply and demand relationships,medical insurance payment policies,compensation mechanisms,and so on.In response to the current situation of price management methods and price levels for medical service in China,various pricing methods such as cost-based pricing,price-regulation pricing,and demand-oriented pricing should be comprehensively utilized to ex-plore a pricing mechanism that separates medical service value from medical service price,human resource value from material con-sumption value,and build a medical service pricing system that could be coordinated with policy objectives.

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.

Research on Calculating the Price Index of Medical Services in Public Hospitals in Tianjin from 2015 to 2021 / 中国卫生经济

Objective:To fully understand the actual changes in medical service prices in Tianjin,analyze and calculate the medi-cal service price index,and provide a reference basis for adjusting medical service prices.Methods:It collects the usage and income of medical service projects in Tianjin from 2014 to 2021,and calculates the Tianjin medical service price index according to the price index calculation formula,compares and analyzes with indicators such as the Tianjin residents'consumption price index,and com-bines Pearson correlation analysis to explore the impact of the classified price index on the overall situation.Results:The measured medical service price index is relatively reasonable;it can better reflect the trend of medical service price changes;the changes in the categorized price index vary widely,and its changes are closely linked to policies related to health care reform.Conclusion:It is needed to further improve the price index analysis,fully analyze the price changes,and constantly improve the price adjustment and analysis mechanism of medical services in Tianjin.