Can Comprehensive Medical Reform Improve the Efficiency of Medical Resource Allocation? Evidence From China.

Objectives: To evaluate the impact of comprehensive medical reform on the efficiency of medical resource allocation in China. Methods: This study employs the Slacks-Based Measure- Directional Distance Function (SBM-DDF) to estimate the efficiency of medical resource allocation (MRAE) in China, using panel data from 30 provinces during 2009-2021. Moreover, a multi-period Difference in differences (DID) model is developed to explore the effect of the comprehensive medical reform pilot (CMRP) strategy on efficiency of medical resource allocation in China. Results: The results show that the average value of China's medical resources allocation efficiency is 0.861 during the sample period. Coastal area has a higher MRAE than that in the inland area. The DID results show that the comprehensive medical reform pilot strategy has a good, long-lasting impact on the efficiency of medical resource allocation. And the results remain valid after a series of robustness analysis. Additionally, the comprehensive medical reform policy has heterogeneous impact on efficiency of medical resource allocation. The promotion effect is only statistically significant in the eastern and central regions, the groups of higher MRAE and larger population size. Conclusion: China's comprehensive medical reform policy can effectively promote the improvement of regional efficiency of medical resource allocation.

The impact of national comprehensive medical reform on residents' medical expenses: Evidence from China.

Residents' high medical expenses is the core challenge that needs to be solved urgently in China's medical reform for a long time. Based on the panel data of 30 provinces in Chinese Mainland during 2011-2019, we evaluate the impact of China's national comprehensive medical reform pilot policy on residents' medical expenses by using the difference-in-differences model. The results show that the pilot policy was generally conducive to reducing residents' medical expenses, resulting in a reduction of 2.13% in per capita medical expenses for inpatients, but the effect on per capita medical expenses for outpatients was insignificant. Mechanism analysis shows that hospital competition and institutional environment played a moderating role in the effect of the pilot policy on residents' medical expenses reduction. The more intense the hospital competition and the better the institutional environment, the more significant of the reduction effect. In addition, the reduction effect of the pilot policy was greater in the central provinces, the provinces with poor medical infrastructure, and the provinces with strong financial strength. This study provides useful policy insights for deepening medical reform and reducing residents' medical expenses.

Practice of Comprehensive Reform with“Zero Drug Profit”and the Like in Jingjiang People’s Hospital / 中国药房

OBJECTIVE:To evaluate the effect of the implementation of comprehensive reform with“zero drug profit”and the like in Jingjiang City People’s Hospital. METHODS:Comparative analysis was made to the data for the adjustment of medical ser-vices and medicine specifications,control of medical expenses,general condition of hospital operation and hospital compensation mechanism before (2012) and after (2013) comprehensive reform in this hospital. RESULTS & CONCLUSIONS:After the com-prehensive reform,the number of medical services provided by this hospital increased from 1 408 to 1 426 (with increase rate of 1.28%),in which the prices of 949 services raised (accounting for 66.55%);the number of medicine specifications decreased from 1 875 to 1 670 (with decrease rate of 10.93%),but the number of essential medicine specifications increased from 261 to 377 (with increase rate of 44.44%);total medical expense and total medical expense per capita respectively increased from 477 565.0 thousand yuan and 633.21 yuan to 524 865.9 thousand yuan and 686.91 yuan(with increase rate of 9.90% and 8.48%), but total medicine expense and total medicine expense per capita respectively decreased from 207 656.8 thousand yuan and 275.33 yuan to 199 052.7 thousand yuan and 260.51 yuan(with decrease rate of 4.14% and 5.38%),the proportion of medicine revenue in total hospital revenue also decreased from 43.48%to 37.92%(with decrease rate of 5.56%);total medical revenue and expendi-ture respectively increased from 453 825.5 thousand yuan and 217 516.3 thousand yuan to 524 865.9 thousand yuan and 263 733.3 thousand yuan (with increase rate of 15.65% and 21.25%),but total drug revenue and expenditure respectively changed from 208 380.8 thousand yuan and 176 054.1 thousand yuan into 199 052.7 thousand yuan and 196 407.5 thousand yuan(with increase rate of -4.48% and 11.56%);although the compensation reached 26 596.0 thousand yuan after raising the prices of hospital ser-vices,the subsidies(including the subsidy for basic construction and equipment procurement,fund for public health services,fund for the retirement conforming to requirements and subsidy for the balance found after checking revenue and expenditure) which should be granted by the government has not become available. It is an urgent issue that government departments and the hospital further improve relevant management policies to promote sound development of medical and healthcare program.