Study on the Changes of Medical Income Structure in Governmentrun Hospitals of Traditional Chinese Medicine from 2012 to 2021

Abstract

Objective To study the changing characteristics and trend of medical income structure in the governmentrun hospitals of traditional Chinese medicine (TCM), evaluate the effects of relevant reform measures, and to put forward corresponding suggestions for further optimizing their income structure. Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out. Then, descriptive analysis method was used to analyze the changes of related indicators. Besides, structural change method was applied to investigate the changes of outpatient income and inpatient income. Results and Conclusion From 2012 to 2021, the growth of medical income in government-run hospitals of TCM tended to be stable, and the proportion of medical service income increased from 22.62% (2012) to 29.38% (2021), but the average annual growth rate was only 0.68%. The main items that caused the change of outpatient income structure were medicine revenue, laboratory tests, diagnosis and treatment, and the cumulative contribution rate was 89.15%. The main items that caused the change of inpatient income structure were medicine revenue, sanitary materials, and auxiliary examinations income, with a cumulative contribution rate of 80.04%. However, the contribution rate of registration, diagnosis, treatment, surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small. The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable, but the medical service income increased slowly, and not all indicators achieved the expectations. To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services, it is necessary to further improve the relevant policy mechanism.

Keywords

government-run hospitals of traditional Chinese medicine / medical expenses / structure optimization / sustainable development

References

[1] The State Council. Notice on Printing and Distributing the Plan and Implementation Plan for Deepening the Reform of Medical and Health System during the Twelfth Five-Year Plan[EB/OL]. (2012-03-21)[2023-03-16]. http://www.gov.cn/zhengce/zhengceku/2012-03/21/content_6094.htm.

[2] General Office of the State Council. Guiding Opinions on Comprehensive Reform of Urban Public Hospitals[EB/OL]. (2015-05-06)[2023-03-16]. http://www.gov.cn/gongbao/content/2015/content_2868467.htm.

[3] Song Jiaming, Wang Xinyuan, Xu Jiamiao, et al. Analysis of medical income of public Traditional Chinese medicine hospitals from 2015 to 2019 - based on the structural change degree and the grey relevancy method[J]. Journal of Nanjing Medical University (Social Science), 2022, 22 (1): 82-87.

[4] Jia Benyuan, Han Hui, Huang Yixiang. Discussion on the structural changes of medical expenditure in Jiangsu and Zhejiang[J]. Health Economics Research, 2022, 39 (5): 33-36.

[5] National Health and Ministry of Finance, et al. Family Planning Commission, National Development and Reform Commission,Notice on Printing and Distributing Several Opinions on Controlling the Unreasonable Increase of Medical Expenses in Public Hospitals[EB/OL]. (2015-10-27)[2023-03-16]. http://www.nhc.gov.cn/tigs/s3577/201511/0038da2bf8fe43d69511fb675e205d37.shtml.

[6] National Health and Ministry of Finance, Central Committee, et al. Family Planning Commission,Notice on Comprehensively Pushing Forward the Comprehensive Reform of Public Hospitals[EB/OL].(2017-04-19)[2023-03-16]. http://www.nhc.gov.cn/tigs/s3581/201704/0563e06eff4441ffa9772dc30b487848.shtml.

[7] Wang Jiaying, Lu Feng, Wang Tianqi, et al. Analyzing the influence of comprehensive reform of medical consumption linkage on outpatient and emergency services and expenses in traditional Chinese medicine hospitals in Beijing[J]. The Chinese Health Service Management, 2021, 38 (9): 660-663.

[8] Yang Jihong, Lu Liqin, Zhang Xinhong. Study on the countermeasures of economic development of public Chinese medicine hospitals in the post-epidemic era[J]. Modern Hospital, 2021, 21 (1): 74-77+81.

[9] Zhu Lei, Lu Huiying. Analysis of impact of medical price reform on income structure of public hospitals[J]. Hospital Management Forum, 2021, 38 (4): 9-12.

[10] Dai Zeyang, Xu Aijun, Liu Yang, et al. To explore the difference of medical income structure between general hospitals and traditional Chinese medicine hospitals in China[J]. Chongqing Medicine, 2022, 51 (17): 1-11.

[11] Zhang Yueli, Dai Xiulan, Xu Yingying, et al. Analysis on the influence of zero profit reform of drug consumables on the economic operation of provincial public hospitals[J]. Health Economics Research, 2021, 38 (4): 54-59.

[12] Tan Ling, Yang Lian, Sun Qun, et al. Comparative study on economic operation of public Chinese medicine hospitals in Sichuan Province[J]. Health Economics Research, 2017 (9): 31-33.

[13] Lu Tingting, Zhang Shuqi. Study on the changes of medical expenses structure in public hospitals in Sichuan Province under the background of new medical reform[J]. Soft Science of Health, 2022, 36 (11): 52-55.

[14] The State Council, the Central Committee of the Communist Party of China. Opinions of the State Council, the Central Committee of the Communist Party of China on Promoting the Inheritance, Innovation and Development of Traditional Chinese Medicine[EB/OL]. (2019-10-26)[2020-05-23]. http://www.gov.cn/zhengce/2019-10/26/content_5445336.htm.

[15] Wang Yitong. The study of Chinese herbal medicine expenditure controlling in medical institutions on national essential drug system[D]. Changchun: Changchun University of Traditional Chinese Medicine, 2015.

[16] Li Jinyan, Xu Mingzhen, Ye Anzhen, et al. Analysis on the operation of public traditional Chinese medicine hospitals after the cancellation of the markup price of drugs and traditional Chinese medicine decoction pieces[J]. Health Economics Research, 2022, 39 (3): 80-82.

[17] Zhan Jifu. Promote the reform of public hospitals with the concept of people first - taking Sanming medical reform as an example[J]. Administrative Reform, 2021 (12): 50-57.

[18] Liu Wensheng. On Sanming medical reform[J]. China Hospital CEO, 2022, 18 (5): 42-43.

[19] Zhang Xinping. Study on pricing mechanism of traditional Chinese medicine medical service items[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2022, 36 (S1): 264-267.

[20] Lin Kai, Wang Zhenyu, Dai Xiaoying, et al. Research on the impact of medical service price adjustment on the income structure of public hospitals: Based on compositional data analysis[J]. China Hospital Management, 2021, 41 (4): 47-51.

[21] National Healthcare Security Administration, National Administration of Traditional Chinese Medicine. Guiding Opinions on Medical Insurance Supporting the Inheritance, Innovation and Development of Traditional Chinese Medicine[EB/OL]. (2021-12-14)[2023-03-16]. http://www.natcm.gov.cn/yizhengsi/zhengcewenjian/2021-12-30/23898.html.

[22] Wu Jianan. Solving the problem of “westernization of Chinese medicine” by paying according to curative value[J]. China Hospital CEO, 2023, 19 (1): 20-23.

[23] Wang Shaojun, Liao Zangyi, Xu Mengqiu, et al. Zhejiang: TCM tilt mechanism under DRG payment system[J]. China Health, 2022 (12): 90-91.

[24] Wu Bingrun, Liu Xinyu. The practice of optimizing the income structure of public Chinese medicine hospitals under the background of performance evaluation[J]. Business Observation, 2021 (27): 94-96.

[25] National Health Commission of the People’s Republic of China, National Administration of Traditional Chinese Medicine. Guiding Opinions on Strengthening the Operation and Management of Public Hospitals[EB/OL]. (2020-12-21)[2023-03-16]. http://www.nhc.gov.cn/caiwusi/s7785t/202012/253d87a373194074b43ce57932b08e60.shtml.

[26] Shi Gang. An empirical analysis of the impact of adjusting the price of medical services on the operation of Chinese medicine hospitals - taking XA Chinese medicine hospital as an example[J]. Western Finance and Accounting, 2020 (6): 69-73.

[27] National Health Commission of the People’s Republic of China, National Healthcare Security Administration, National Administration of Traditional Chinese Medicine, et al. Notice on Printing and Distributing Administrative Measures for Mutual Recognition of Inspection Results of Medical Institutions[EB/OL]. (2022-02-14)[2023-03-16]. http://www.nhc.gov.cn/yzygj/s7659/202202/b2ea61aed69746e195e79d4b505ee8b4.shtml.

[28] Song Daping, Zhang Zhisheng, Cui Yaru, et al. General thought on health reform in the 14th five-year plan period[J]. Chinese Health Economics, 2021, 40 (5): 5-7.