Insights of drug zero-profit reform at county-level public hospitals in Zhejiang Province / 中华医院管理杂志

ABSTRACT

This paper presented the practice of Zhejiang in introducing the drug zero-profit reform.A comparative analysis was made to the pilot county hospitals regarding their business performance,patients' burden,financial subsidy and medical insurance expenditure.The reform has scored a success as expected with the following outcomes:sharp rise in medical services volume,medical income and financial aid on one hand; drop of the proportion of drug income and changes in the medical income makeup; controlled increase of average cost of outpatient and inpatient care,and significant drop of pharmaceutical costs; increased expenditure yet stable operation of medical insurance funds;proportional increase of medical insurance compensation,with drops of the proportion of both out-ofpocket expenses and visits to doctors out of their county.This reform,however,has such shortcomings as followsinsufficient adjustment toward true costs of medical services,lack of a clear and sustainable financial compensation mechanism,and that of supporting measures.Based on these,the authors call for accelerated payment system reform,dynamic and scientific adjustment of medical service prices,exploration of clear financial compensation methods,optimization of internal management of hospitals,and acceleration of the formation of a medical staff income distribution mechanism.