Abstract: Objective To analyze the changes of the medical expenses and cost structure of medical insurance before and after public hospital medical price reform in Hebei province, and evaluate the effect of the medical price reform. Methods All the data before and after the medical price reform were collected from the information system in the public hospital, the data were analyzed on the medical expenses and cost structure of medical insurance. Results After the medical reform, the average cost per time of outpatient increased slightly by the proportion of 5.34%(17.73 yuan)because of the cost increase of treatment and laboratory primarily. However, the average cost per time of inpatient decreased significantly by the proportion of 2.28%(378.71 yuan), with the decrease of medicine fees(13.76%, 931.14 yuan)and cost of sanitary materials( 12.15%, 449.06 yua). On the other hand, the cost of nursing(109.89%), consultation(21.63%), surgery(18.66%)and treatment(17.87%)had increased significantly. In terms of single disease, the average cost per time of both cerebral infarction and coronary heart disease decreased with the cost of 1 664.45 yuan and 2 774.05 yuan separately, however the average cost per time of chronic obstructive pulmonary disease increased(315.88 yuan). Conclusion After the reform in public hospitals, the cancellation of the drug markup policy was fully implemented, which reduced the total proportion of drug costs, and increase the proportion of nursing, consultation, surgery and treatment, the cost medical structure were optimized.

Key words: pharmaceutical price reform, public hospitals, medical expenses, cost structure