context: The drop in the birth rate hit the obstetrics departments first. Attempting to maintain obstetrics services while improving its quality to encourage childbirth, the National Healthcare Security Administration issued a ‘Guideline for pricing obstetric medical services (trial)’ that re-categorised obstetric pricing items based on a national standard based on resource consumption and technical difficulty. Existing local obstetric pricing items have been consolidated into 30 items, making them better suited to clinical practice.
Duan Tao 段涛 Shanghai First Maternity and Infant Health Hospital obstetrics chief physician said the consolidation of pricing items is conducive to improve services in obstetrics and can better meet the diversified needs from patients: 'this is a good start'.
Previously, the pricing of medical services was managed by provincial pricing departments, which led to
- significant differences in the number of pricing items between provinces
- variations in the names, content and pricing units of the items
- discrepancies in charges for consumable materials
Wang Fan 王凡 Longyan First Hospital stated that the previous pricing item categorisation of obstetric services can no longer help to create a ‘birth-friendly society’ due to
- overly detailed and granular pricing
- cannot adequately accommodate new technologies and their associated costs
- does not align well with the rapid integration of new technologies into clinical practice
NHSA (National Healthcare Security Administration) quoted a research indicating around 13 percent of young women in China are fearful of pregnancy and birth giving. To address this
- the new guidelines established items for ‘labour analgesia’, ‘doula delivery’ and ‘family-centred delivery’
- supporting medical institutions in providing patient-centred, humane birthing services
- previous challenges for introducing such services were due to
- lack of independent pricing standards, hence charged under existing items, which reduced the incentive to provide such services
- a limited number of anesthesiologists
According to Wang, the introduction of patient-focused pricing service items
- better respect the labour value of medical personnel
- boosts the morale of obstetric workers
- reduces workload for obstetricians
To enhance the charging standards for obstetrics departments, the guidelines have made several adjustments, including giving additional or separate pricing items for high-value technical labour and high-risk complex situations to reward more technically advanced services.