Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China
Abstract Background China carried out a comprehensive drug price reform (CDPR) in 2017 to control the growing expense of drug effectively and reduce the financial burden of inpatients. However, early studies in pilot regions found the heterogeneity in the effectiveness of CDPR from different regions...
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doaj-c85288a6b3b14b29ba494c1e6f8896bf2020-11-25T03:52:44ZengBMCInternational Journal for Equity in Health1475-92762020-08-0119111010.1186/s12939-020-01246-9Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western ChinaTaoyu Lin0Zhaohui Wu1Menming Liu2Xiangwei Wu3Xinping Zhang4School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and TechnologySocial Insurance Administration Bureau in Shihezi CityThe First Affiliated Hospital, School of Medicine, Shihezi UniversityThe First Affiliated Hospital, School of Medicine, Shihezi UniversitySchool of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background China carried out a comprehensive drug price reform (CDPR) in 2017 to control the growing expense of drug effectively and reduce the financial burden of inpatients. However, early studies in pilot regions found the heterogeneity in the effectiveness of CDPR from different regions and other negative effects. This study aimed to evaluate the effects of the reform on medical expenses, medical service utilisation and government financial reimbursement for inpatients in economically weaker regions. Methods Shihezi was selected as the sample city, and 238,620 inpatients, who were covered by basic medical insurance (BMI) and had complete information from September 2016 to August 2018 in public hospitals, were extracted by cluster sampling. An interrupted series design was used to compare the changing trends in medical expenses, medical service utilisation and reimbursement of BMI for inpatients before and after the reform. Results Compared with the baseline trends before the CDPR, those after the CDPR were observed with decreased per capita hospitalisation expenses (HE) by ¥301.9 per month (p < 0.001), decreased drug expense (DE) ratio at a rate of 0.32% per month (p < 0.05) and increased ratio of diagnosis and treatment expenses (DTE) at a rate of 0.25% per month (p < 0.01). The number of inpatients in secondary and tertiary hospitals declined by 458 (p < 0.001) and 257 (p < 0.05) per month, respectively. The BMI reimbursement in tertiary hospitals decreased by ¥254.7 per month (p < 0.001). Conclusion The CDPR controlled the increase in medical expenses effectively and adjusted its structure reasonably. However, it also reduced the medical service utilisation of inpatients in secondary and tertiary hospitals and financial reimbursement for inpatients in tertiary hospitals.http://link.springer.com/article/10.1186/s12939-020-01246-9Comprehensive drug price reformMedical expenseMedical service utilisationReimbursementBasic medical insuranceInterrupted time-series |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Taoyu Lin Zhaohui Wu Menming Liu Xiangwei Wu Xinping Zhang |
spellingShingle |
Taoyu Lin Zhaohui Wu Menming Liu Xiangwei Wu Xinping Zhang Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China International Journal for Equity in Health Comprehensive drug price reform Medical expense Medical service utilisation Reimbursement Basic medical insurance Interrupted time-series |
author_facet |
Taoyu Lin Zhaohui Wu Menming Liu Xiangwei Wu Xinping Zhang |
author_sort |
Taoyu Lin |
title |
Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China |
title_short |
Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China |
title_full |
Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China |
title_fullStr |
Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China |
title_full_unstemmed |
Evaluation of the effectiveness of comprehensive drug price reform: a case study from Shihezi city in Western China |
title_sort |
evaluation of the effectiveness of comprehensive drug price reform: a case study from shihezi city in western china |
publisher |
BMC |
series |
International Journal for Equity in Health |
issn |
1475-9276 |
publishDate |
2020-08-01 |
description |
Abstract Background China carried out a comprehensive drug price reform (CDPR) in 2017 to control the growing expense of drug effectively and reduce the financial burden of inpatients. However, early studies in pilot regions found the heterogeneity in the effectiveness of CDPR from different regions and other negative effects. This study aimed to evaluate the effects of the reform on medical expenses, medical service utilisation and government financial reimbursement for inpatients in economically weaker regions. Methods Shihezi was selected as the sample city, and 238,620 inpatients, who were covered by basic medical insurance (BMI) and had complete information from September 2016 to August 2018 in public hospitals, were extracted by cluster sampling. An interrupted series design was used to compare the changing trends in medical expenses, medical service utilisation and reimbursement of BMI for inpatients before and after the reform. Results Compared with the baseline trends before the CDPR, those after the CDPR were observed with decreased per capita hospitalisation expenses (HE) by ¥301.9 per month (p < 0.001), decreased drug expense (DE) ratio at a rate of 0.32% per month (p < 0.05) and increased ratio of diagnosis and treatment expenses (DTE) at a rate of 0.25% per month (p < 0.01). The number of inpatients in secondary and tertiary hospitals declined by 458 (p < 0.001) and 257 (p < 0.05) per month, respectively. The BMI reimbursement in tertiary hospitals decreased by ¥254.7 per month (p < 0.001). Conclusion The CDPR controlled the increase in medical expenses effectively and adjusted its structure reasonably. However, it also reduced the medical service utilisation of inpatients in secondary and tertiary hospitals and financial reimbursement for inpatients in tertiary hospitals. |
topic |
Comprehensive drug price reform Medical expense Medical service utilisation Reimbursement Basic medical insurance Interrupted time-series |
url |
http://link.springer.com/article/10.1186/s12939-020-01246-9 |
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