Evaluation of the Effect of the Implementation of National Essential Medicine System on Health Service Be-havior and Operation Status of Township Hospitals in a Province / 中国药房

ABSTRACT

OBJECTIVE:To provide reference for the further implementation of national essential medicine system of township hospitals. METHODS:5% township hospitals in a province were collected as sample by using random cluster sampling method, and statistics,comparison and evaluation was made by issuing questionnaires to get health resources distribution status,health ser-vice status and income and expenditure status before(in 2009 and 2010)and after(from 2011 to 2013)the implementation of na-tional essential medicine system of township hospitals. RESULTS:Totally 46 township hospitals were surveyed and totally 46 ques-tionnaires of township hospitals were recycled. Average number of beds in township hospitals increased from 15.1 beds in 2009 to 19.4 beds in 2013. Average annual outpatients increased from 11 200 in 2009 to 16 100 in 2013,and average number of hospital discharge increased from 644 in 2009 to 924 in 2013. The proportion of government financing to total income increased from 25.9% in 2009 to 47.1% in 2013,proportion of drug income to the total income decreased from 54.9% to 29.7%,drug profit rate decreased from 25.5% to 3.7%,and proportion of township hospital under deficit decreased from 17.4% to 4.3%. Average time that residents see a doctor in township health center increased from 0.47 in 2009 to 0.74 in 2013,and cost of average hospitaliza-tion and outpatient drugs decreased from 805 to 718 and 28.1 to 24.1,respectively. CONCLUSIONS:The implementation of nation-al essential medicine system has no negative effect on outpatient service,but first inhibits then promotes the inpatient services. Na-tional essential medicine system has effectively cut down the financial burden of drugs,but it has no effect on total health burden. It is difficult to realize the excessive rapid rise of health ex-pense by the single implementation of essential medicine sys-tem,and it needs comprehensive reform,collaboration and in-teraction of medicine and health to effectively relieve the prob-lem of“expensive ill”.