ArticleInternational journal for equity in health2020
Different impacts of the zero-markup drug policy on county general and traditional Chinese medicine hospitals: evidence from Shandong province, China.
Article in International journal for equity in health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review of the Effect of a Zero-Markup Policy for Essential Drugs on Healthcare Costs and Utilization in China, 2015-2021.Frontiers in medicine · 2021Pooled it
- Effect of no eyeglasses sales on the quality of eye care: an experimental evidence from China.BMC public health · 2024Trial
- Evaluating the Zero-Markup Drug Policy's Effects on Financial Burden and Pharmaceutical Channel Migration: A Structural Variation and Interrupted Time Series Analysis from Hubei, China.Journal of healthcare leadership · 2026Article
- Traditional Chinese medicine reimbursement reform in China: implementation progress, policy constraints, and optimization strategies.Frontiers in public health · 2026Article
- Impact of pilot public hospital reform on efficiencies: a DEA analysis of county hospitals in East China, 2009-2015.Health economics review · 2025Article
- Analysis of structural variations and effects of the national volume-based procurement policy on inpatient costs: a real world study of osteoporotic hip fractures in Shanghai, China.Frontiers in public health · 2025Article
- Impact of national drug price negotiation policy on the accessibility and utilization of PCSK9 inhibitors in China: an interrupted time series analysis.International journal for equity in health · 2024Article
- Impacts of national volume-based drug procurement policy on the utilization and costs of antihypertensive drugs in a Chinese medicine hospital: an interrupted time series analysis of 5138 patients.Frontiers in pharmacology · 2024Article
- 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.Frontiers in health services · 2023Article
- The Effects of Monetary Incentives on Physicians' Effort and Patient Satisfaction: Understanding the Links between Monetary Incentives and Physicians' Effort.International journal of environmental research and public health · 2022Article
- The impact of zero markup drug policy on patients' healthcare utilization and expense: An interrupted time series study.Frontiers in medicine · 2022Article
- Impact of zero-mark-up medicines policy on hospital revenue structure: a panel data analysis of 136 public tertiary hospitals in China, 2012-2020.BMJ global health · 2021Article
- COVID-19 as an opportunity to reveal the impact of large hospital expansion on the healthcare delivery system: evidence from Shanghai, China.Annals of translational medicine · 2021Article
- Will the zero-margin drug policy reduce the economic burden of stroke patients in China?Journal of global health · 2021Article
- Impacts of the COVID-19 Pandemic on Public Hospitals of Different Levels: Six-Month Evidence from Shanghai, China.Risk management and healthcare policy · 2021Article
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5 authors.
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Abstract
backgroundAs a key part of the new round of health reform, the zero-markup drug policy (ZMDP) removed the profit margins of drug sales at public health care facilities, and had some effects to the operation of these institutions. This study aims to assess whether the ZMDP has different impacts between county general and traditional Chinese medicine (TCM) hospitals.
methodsWe obtained longitudinal data from all county general and TCM hospitals of Shandong province in 2007-2017. We used difference-in-difference (DID) method to identify the overall and dynamic effects of the ZMDP.
resultsOn average, after the implementation of the ZMDP, the share of revenue from medicine sales reduced by 16.47 and 10.42%, the revenue from medicine sales reduced by 24.04 and 11.58%, in county general and TCM hospitals, respectively. The gross revenue reduced by 5.07% in county general hospitals. The number of annual outpatient visits reduced by 11.22% in county TCM hospitals. Government subsidies increased by 199.22 and 89.3% in county general and TCM hospitals, respectively. The ZMDP reform was not significantly associated with the revenue and expenditure surplus, the number of annual outpatient visits and the number of annual inpatient visits in county general hospitals, the gross revenue, the revenue and expenditure surplus and the number of annual inpatient visits in county TCM hospitals. In terms of dynamic effects, the share of revenue from medicine sales, revenue from medicine sales, and gross revenue decreased by 20.20, 32.58 and 6.08% respectively, and up to 28.53, 63.89 and 17.94% after adoption, while government subsidies increased by around 170 to 200% in county general hospitals. The number of annual outpatient visits decreased by 9.70% and up to 18.84% in county TCM hospitals.
conclusionThe ZMDP achieved its some initial goals of removing the profits from western medicines in county hospitals' revenue without disrupting the normal operation, and had different impacts between county general and TCM hospitals. Meanwhile, some unintended consequences were also recognized through the analysis, such as the decline of the utilization of the TCM.
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