AUTHOR=Pan Lin , Xiao Kai , Zhu Huanhuan , Luo Li 

TITLE=The impacts of public hospital comprehensive reform policies on hospital medicine cost, revenues and healthcare expenditures 2014–2019: An analysis of 103 tertiary public hospitals in China

JOURNAL=Frontiers in Health Services

VOLUME=Volume 3 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/health-services/articles/10.3389/frhs.2023.1079370

DOI=10.3389/frhs.2023.1079370

ISSN=2813-0146

ABSTRACT=Objective To explore the impact of implementing the comprehensive public hospital reform policy (CPHRP) on medicine costs, revenues and medical expenditures in China's tertiary public hospitals. 
Methods This study used data from local administrations to obtain operational data of healthcare institutions and medicine procurement data for 103 tertiary public hospitals from 2014 to 2019. The propensity matching score method and the difference-in-difference method were used jointly to assess the impact of reform policies on tertiary public hospitals.
Results After the implementation of the policy, differences between control and intervention group of the sample institutions in medicine revenue decreased by ¥ 86.3 million (p=0.076); medical service revenue increased by ¥ 108.5 million (p<0.001); government financial subsidies increased by ¥ 20.3 million (p=0.085); the average medicine cost per outpatient and emergency visit decreased by ¥ 15.2 (p=0.063); the average medicine cost per hospitalization decreased by ¥ 504 (p= 0.040); however, The medicine cost decreased by ¥ 38.2 million (p=0.419), the average cost per visit for outpatient and emergency decreased by ¥ 0.562 (p=0.966), the average cost per hospitalization decreased by ¥ 152 (p=0.844), which are not significant.
Conclusions The implementation of reform policies has adjusted the revenue structure of public hospitals, the proportion of drug revenue in public hospitals decreased, while the income of medical services and government subsidies increased, and the proportion of service income in the income structure increased. Meanwhile, the average outpatient and emergency drug cost per time and the average inpatient drug cost per time were reduced, which played a certain role in reducing the disease burden of patients.