Impact study of county-level public hospital reform on the expenditure of medical insurance fund / 中华医院管理杂志

ABSTRACT

Objective To learn the impact of county-level public hospital reform on the expenditure of medical insurance fund.Methods Using the difference-in-differences model to analyze the differences incurred in both hospitalization expenditure and expenditure of the fund at two county-level public hospitals.Results The reform has reduced both the drug expenditure and examination expenses per hospitalization at such hospitals at 318.5 yuan and 410.2 yuan respectively,yet with an increase of treatment expenditure of 535.6 yuan per hospitalization.No significant growth rate was incurred by the reform to the medical insurance fund.A significant difference of both hospitalization expenditure of patients and the fund was found among patients covered by different medical insurance funds.Conclusions The reform has achieved initial success at such hospitals in reducing inpatients′drug and examination expenditures.However,it is important to prevent from the treatment expenditure from an offset increase;to further reform the payment modes for safety of the fund,to remove the differentiation found in the existing medical insurance system,and leverage the regulating role of various medical insurance funds on medical service behaviors and expenditures.