Abstract
This study analyzed performance of public hospitals and regional differences in performance following reform of medical service prices in Guangdong province, China. From three cities in four regions, we randomly selected a total of 12 traditional Chinese medicine hospitals and 12 general tertiary hospitals. Six questionnaires were completed by the hospitals, using 2014–2018 internal data. Principal components analysis was used to compare performances of the hospitals and regions following price reform. The extent to which medical service prices were adjusted varied considerable for different procedures in the same region and for the same category of procedures among regions. After reform, compensation for medical services in public hospitals reached the target of 80%, except in the Western region. However, annual growth of costs to patients was generally above 4%; the burden on patients was not alleviated by fee control. Reforms were more effective for comprehensive than Chinese traditional medicine hospitals. Performance scores of general hospitals in the Pearl River Delta, Eastern, Western, and Northern regions were 1.24, 1.16, −0.22, and −1.01, respectively. This is consistent with ranking by level of economic development of each region. The government should implement a regional medical service pricing mechanism. Additionally, comprehensive and traditional Chinese medicine hospitals should each have appropriate pricing policies. Future policies should focus on controlling costs incurred by patients.
Highlights
In recent years, the Chinese government has enacted significant medical service price reforms in public hospitals to solve the problem of expensive medical treatment
Based on principal components analysis, we calculated the performance of 24 public hospitals in 12 cities, and compared the overall performance of four regions, focusing on the relationship between regional differences and price reform performance
This study is the first to explore the specific performance differences related to medical service price adjustment policies in different regions
Summary
The Chinese government has enacted significant medical service price reforms in public hospitals to solve the problem of expensive medical treatment. The price of medical services is the monetary expression of the medical service’s value, including outpatient, hospitalization, examination, treatment, testing, surgery, and so on. Prior to the medical service price reform, patients who received drugs from urban public hospitals in the Guangdong Province of China were required to pay 12–15% of the drug price. Guangdong Province enacted medical service price reforms, by abolishing drug costs to patients. The policy stipulates that 80% of the income from drug reductions will be compensated by adjusting the hospital medical prices. The policy optimizes the income structure of hospitals by reducing the proportion of drug revenue and increasing the income of technical services such as diagnosis, surgery and treatment [3]
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