Economic Performance of Community Health Centers in Wuhan before and after the China’s Health Care Reform Lauched in 2009

Abstract

Objective: To analysis the economic performance of community health centers in Wuhan before and after the China’s health care reform lauched in 2009.

Methods: Income and expenditure, patients flows, efficiency and effectiveness of health service provision of Wuhan community health centers were analyzed by using Health Financial Annual Report 2008—2016 in Wuhan.

Results: Annual average growth rate of total income in Wuhan community health centers was 21.4% during 2008—2016, and distributable balances were below zero in a continuous expansion trend. The share of government subsidy increased from 32.4% in 2008 to 60.0% in 2016, of which subsidy for public health services increased by 7.7%; the proportion of medical income was generally declining, from 59.4% in 2008 to 37.7% in 2016, of which the proportion of drug income fell from 38.9% in 2008 to 32.3% in 2016. The number of outpatient and emergency visits increased from 2.005 million in 2008 to 3.988 million in 2014, and decreased to 3.592 and 2.984 million in 2015 and 2016 respectively. The number of discharged patients increased from 12 000 in 2008 to 73 000 in 2014, and fell to 53 000 and 41 000 in 2015 and 2016 respectively. The utilization rate of beds decreased to 44.4% by 2016 from 80.9% in 2009. The income from medical insurance for 100 yuan fixed assets (excluding drug income) increased from 61.2 yuan in 2008 to 135.1 yuan in 2011, in a generally decline trend. It fell to 66.9 yuan in 2016.

Conclusion: Economic operation of Wuhan community health centers was lower than the national average since the China’s health care reform lauched in 2009; the public health service function has been enhanced, but the medical services function has been weakened. We recommend continuously improving the medical service capacity of community health centers and mobilizing the enthusiasm of community staff to improve work efficiency and ultimately promote hierarchical diagnosis and treatment.