A Comparative Study on Impact of Outpatient Mutual Assistance System on Medical and Pharmaceutical Costs of TCM and Non-TCM Hospitals
Chen Meng'en
Wang Yan
Zhang Xiaoxi
Yuan Youshu
Hou Haojia
Wang Jiayi
Yang Jingyu
Wang Zhiwei
Zhang Qian
Abstract：Objective:To analyze the effects of the employee medical insurance outpatient mutual assistance system implement on medical and pharmaceutical costs between traditional Chinese medicine(TCM)and non-TCM hospitals.Methods:Using medical insurance settlement data for hypertensive outpatients in Lanzhou from 2022 to 2023,univariate analysis and interrupted time-series models were implemented to compare changes before and after the implement.Results:In TCM hospitals,there were statistically significant differences in the average per-visit costs of Western medicines,Chinese herbal medicines,and medical service items before and after the implement(P＜0.05).Additionally,the average per-visit total medical costs,Chinese herbal medicine cost,and medical service item cost all showed a significant downward trend after the implement(P＜0.05).In non-TCM hospitals,the differences in the average per-visit total medical costs,Western medicine cost,proprietary Chinese medicine cost and other items before and after the implement were statistically significant(P＜0.05).Furthermore,the average per-visit total medical costs,Western medicine cost,and proprietary Chinese medicine cost showed a significant downward trend after the implement(P＜0.05).Conclusion:The employee medical insurance outpatient mutual assistance system has had a positive impact on controlling medical and pharmaceutical costs in both types of hospitals,with non-TCM hospitals showing better cost control outcomes.However,the control of certain cost components in both types of hospitals still requires further improvement.It is essential to continuously refine the employee medical insurance outpatient mutual assistance system,promote multi-stakeholder collaborative governance,and implement differentiated payment strategies to enhance the level of outpatient benefit protection.
Keywords：employee medical insurance outpatient mutual assistance systemtraditional Chinese medicine hospitalsNone-traditional Chinese medicine hospitalsmedical and pharmaceutical coststwo-group interrupted time-series model
Publication Date：2025-12-05
Online Publishing Date：2026-01-05(First online date of this platform, not the publication date of the document)
Pages：6( 13-18 )