Study of the impacts of global budget on service efficiency and costs of hospital services in Shanghai

Abstract

Objective To analyze such indices as quantity of care, bed turnover, medical costs and medical insurance in Shanghai′s tertiary hospitals, before and after the implementation of the global budget for a study of the present medical insurance payment in Shanghai. Methods With SPSS 21.0, this thesis conducted a descriptive statistic analysis on changes of such indices as service volume, and efficiency in medical services, medical costs, before and after the implementation of the global budget. Results After the implementation, the year-on-year growth of the number of outpatients and emergency visits, and patients discharged decreased about 4.0%in such hospitals.From 2008 to 2012, the average days of stay dropped by 4.0 days in total.Before the implementation, the growth rate of total costs of medical services was 21.7%, which was only 12.6%in 2012.For those patients under coverage, the number of outpatients and emergency visits, and inpatients discharged kept increasing since 2010.The ratio of total medical insurance cost in the total medical costs fell below 39.0%, dropping year on year.The accumulated completion rate of medical insurance is over 100.0%each year, with overspending each year as well, and such total for drugs covered by medical insurance falls below 100.0%each year. Conclusion The global budget helps push up volume and efficiency of medical services, and helps control medical expense significantly.However, quality of care for patients is expected to improve, and so is further control over the total amount of global budget. Key words: Medical insurance; Global budget; Efficiency in medical services; Costs of medical services