PHP95 - THE STUDY OF DYNAMIC ADJUSTMENT MECHANISM OF MEDICAL SERVICE PRICE IN CHINA

Abstract

The revenue of public hospitals in China mainly come from medical service charge, drug markup and financial subsidy. Drug markup was the most important part, while the price of medical services was under strict regulation. This study aims to investigate the current situation of medical service price adjustment after abolishing the drug markup in 2017. A literature review were conducted with 31 provinces involved. Issues related to medical services price adjustment like organization structure, procedures, period, startup mechanism, pricing and adjustment method, coordination and monitoring were covered in the expert consultations and case studies in selected provinces. Raising the medical service (not including drugs) price in general gained consensus in the wave of public hospital reform in order to compensate the loss of drug markup. While the financial subsidy maintaining at a historical level (about 10% or less of revenue), 80% or higher proportion of revenue relied on the rise of medical service, with the remaining compensated by strengthening internal cost management. Within the thousands of medical service items, those with high technical value such as nursing care and operation were in the list of increasing price, while those depending more on equipment like laboratory tests were to be in the price-cut list. Currently in most provinces the price adjustment were judged by experts and to some extent made reference to neighboring provinces with varied adjustment cycle and startup mechanism (eg., in relation to CPI). Decentralization of price management in some provinces also made the medical service price adjustment sophisticated. Dynamic adjustment mechanism of medical service price is still under construction in order to appropriately reflect the change of cost and hospital revenue structure, as well as the balancing of decisions among hospital revenue, financial burden of patients and medical insurance expenditure.