At a time when the national negotiations on centralized procurement and the deepening of medical insurance payment reform, in addition to the unemployed medical representatives, many hospitals cannot escape the fate of closing down and being auctioned.
On April 23, after the bankruptcy and reorganization of Hangzhou Dacheng Hospital, the starting price was 10.59 million yuan;
On April 21, Suqian Jiabao Children's Hospital conducted the third bankruptcy auction, with a starting price of 133.728 million yuan;
On April 24, Shanxi Sanji Cerebrovascular Disease Hospital will recruit investors after bankruptcy reorganization;
On April 24, Nanjing Huashijiabao Maternity Hospital Co., Ltd., held by Suqian Maternity Hospital, will start the eighth auction with 58.87125 million yuan...
According to incomplete statistics, since the beginning of this year, more than 100 hospitals across the country have declared bankruptcy due to debt problems, including some public hospitals. These questions caused an uproar on the internet as to why a hospital with so many daily visits continues to close.
According to the report of the National Health Commission, 43.5% of the 2,508 tertiary public hospitals participating in the evaluation were in a loss-making state. In 2022, hospitals across the country will lose 1 trillion yuan, equivalent to a daily loss of nearly 3 billion, while in 2019, the proportion of tertiary public hospitals that lost money was less than 20%. In addition, according to the "China Health Statistics Yearbook 2021", 23,500 non-public medical institutions across the country have a total loss of 130 billion yuan a year, with an average loss of 5.53 million yuan per company.
Since the pandemic,
More than 2,000 hospitals have closed
In fact, it is not surprising that public hospitals have lost money, and closures are relatively rare. Last year, the news of the closure of a public secondary hospital in Leshan City, Sichuan Province, was on the hot search.
According to relevant sources, as early as before the epidemic, the Fourth People's Hospital of Leshan City, Sichuan Province lost 20 million yuan, owing money to multiple suppliers, ranging from several million each, and the advent of the epidemic became the last straw that crushed the hospital. However, since it is a public institution, it cannot declare bankruptcy, so the staff in the hospital and the subsequent diversion work have become a thorny problem.
The difficult operation of private hospitals is even more cruel, selling oneself to survive is a good ending, and more is direct bankruptcy liquidation. Yu Xiaobao, vice president of the Private Hospital Management Branch of the China Hospital Association, said that since the epidemic, more than 2,000 private hospitals have gone bankrupt and closed.
Chongqing Huayi Hospital closed down and was filed for bankruptcy liquidation;
Yibin Aidi Eye Hospital Co., Ltd. is seriously insolvent and bankrupt;
Minfeng Bank applied for bankruptcy liquidation of the maternity hospital on the grounds that Suqian Maternity Hospital Co., Ltd. could not pay off its debts when due;
Suqian Workers' Hospital was forced to liquidate by the court on the grounds that it had not paid off its debts and failed to perform its liquidation obligations in a timely manner after its dissolution;
Guangzhou Guanghe Hospital was dissolved, failed to liquidate in time, and was applied for compulsory liquidation;
Wuhu Jinling Hospital Co., Ltd. filed for bankruptcy liquidation on the grounds of poor operation and serious insolvency;
The pediatric outpatient department in Shenzhen could not pay off its debts when due, became insolvent, and was liquidated by bankruptcy;
Guangdong South China Stomatological Hospital could not pay off its debts due and its assets were insufficient to pay off all its debts, and there was no property to distribute, so it requested that the stomatological hospital be declared bankrupt...
A large number of hospitals are facing difficulties in transformation,
Losses are inevitable
The reason for the loss is, on the one hand, due to the impact of the three-year epidemic, the number of patients has declined, and the population has concentrated in large hospitals in large cities, and the daily operation of primary medical institutions and private hospitals has been greatly affected; On the other hand, the large financial investment in epidemic prevention may affect the issuance of some funds and subsidies, and the amount allocated has shrunk.
At the same time, during the epidemic, grassroots hospitals have borne more prevention and control work, equipment procurement, and wear and tear have increased operating costs. In addition, public hospitals are also experiencing a painful transition period after the implementation of centralized procurement, national talks, and medical insurance payment reform (DRG/DIP), selling drugs at zero price difference, and medical insurance paying according to effect, so that the profitable items of past hospitals - "drugs, consumables, heads" have become cost items, and some hospital departments have even made patients have to be discharged for 15 days in order not to lose money, reducing the number of low-profit disease admissions.
The first to feel the chill is the county hospitals, which are very dependent on the medical needs of local patients, but their own business capabilities are not strong enough, and they are easily robbed of patients by large hospitals in nearby big cities, making hospital operations difficult.
Recently, data released by the Department of Medical Administration of the National Health Commission shows that not only the proportion of drug revenue in county hospitals across the country has decreased year by year, but also the proportion of "medical service + drug" revenue has decreased year by year (59.83% in 2020, 59.46% in 2021, and 58.92% in 2022). This means that medical service revenue cannot fill the hole of declining drug revenue; It also means that the proportion of other income such as financial appropriations in county hospitals across the country is rising year by year; It also reflects the weakness of the county hospital's own hematopoietic capacity.
The proportion of medicine in 2116 county hospitals nationwide
Source: National Health Commission
"With the full implementation of the DRG payment reform this year, it is basically impossible for our hospital to make a profit." A doctor from a hospital told Xinkangjie that the policy has been fully rolled out, but the transformation of the hospital cannot be in place in one step, coupled with the past expansion, equipment purchase and other loan expenditures, although the financial allocation has been stable and rising in recent years, but the current capital turnover of the hospital is still very tight.
brief summary
Repeated construction of inefficient and low-level medical services cannot meet the medical needs of the mainland's aging population and low birthrate. Whether it is the transformation of public hospitals or private hospitals, it is the need of the times to change, and the closure of poorly operated hospitals and asset restructuring are positive elimination mechanisms. The medical resources of large cities have very strong strength in terms of quantity and quality, they are the main force of change but not the most critical difficulty, how to make the successful transformation of primary medical institutions in most small and medium-sized cities in the mainland is related to the success or failure of this big change.
Author | Twilight
Source | New Kangjie
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