Research on the influence of internal and external economic incentives of Sanming county medical alliance on medical service supply

Corresponding author: Xiang Li, xllyf@126.com

DOI: 10.12201/bmr.202209.00006

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  Abstract: Objective: To explore the changes of medical service supply in Sanming under the internal annual salary point system reform, the external county medical alliance package payment reform and a series of other supporting policies, and the synergistic influence mechanism of internal and external economic incentive policies. Methods: Taking Sanmings annual salary point system reform in August 2015, and the package payment reform of county medical alliance in January 2018 as the policy intervention points. The monthly data changes in the three policy periods were analyzed by using the interrupted time series (ITSA) regression model. Results: After the implementation of the annual salary point system, the outpatient and emergency visits of the whole city and grassroots hospitals were significantly increased, and the outpatient and emergency visits of the hospital still kept the upward trend. After the implementation of package payment reform of county medical alliance, the upward trend of outpatient and emergency visits and inpatients in the whole city, grassroots hospitals and hospitals slowed down significantly, and the growth rate of the proportion of outpatient and emergency visits in grassroots hospitals declined significantly. Conclusion: Exerting the macro-control function of external economic incentives can regulate the behavior of excessive medical service supply caused by unreasonable internal economic incentives. Only coordinated reform with internal and external economic incentives can smoothly promote the implementation of hierarchical medical system.

  Key words: Sanming medical reform; County medical alliance; Payment method; Salary system; Medical service supply

  Submit time: 2 September 2022

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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