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Objective:To analyze the impact created by the reallocation of a tertiary hospital on the neurosurgery inpatients volume in the functional core area of Beijing as the capital city, for reference to improve the healthcare resource reallocation policy.Methods:The data were obtained from the data sheet of discharged patients and the monthly report of medical statistics in Beijing. The study analyzed the average monthly neurosurgery inpatients volume, surgical beds and bed utilization rate of secondary or higher level hospitals from the core area, a tertiary hospital(hospital A), and as well as three tertiary hospitals(hospitals B, C and D)within 5 kilometers of Hospital A original location before and after the reallocation of Hospitls A. Periods of November 2017 to August 2018 and November 2018 to August 2019 respectively serve as the time frame before and after the relocation of Hospital A.Results:After the reallocation, the average monthly total inpatients volume, inpatients volume from other places, and local inpatients volume of neurosurgery at secondary or higher level hospitals in the core area decreased from 2 238, 1 610 and 628 to 1 526, 996 and 530 respectively. The inpatients volume changes were all statistically different( P<0.001). The number of neurosurgery inpatients in Hospital A and Hospital B increased from 983 and 659 to 1 316 and 934 respectively, as well as the number of neurosurgery inpatients in Hospital C and Hospital D did not change much. After the relocation of Hospital A, the number of surgical beds in secondary or higher level hospitals in the core area was reduced from 5 213 to 4 782, while that of Hospital A increased from 557 to 750, while the other three tertiary hospitals remained unchanged. The changes of bed utilization rate of the 4 hosptials were all less than 7.00%. Conclusions:After the reallocation Hospital A, the neurosurgery inpatient volume in the core area decreased, which was mainly contributed by the decrease of patients from other places, suggesting a positive outcome by the reallocation of healthcare resources in Beijing. On the other hand, it is necessary to study the influence of alternative medical resources on the reallocation effect.
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Objective:To evaluate the effect of the comprehensive reforms of clinic-pharmacy separation and medical-consumables expenditure linkage in Beijing.Methods:Monitoring data of the comprehensive reforms were collected from 363 public medical institutions in Beijing between January 2016 and December 2019, while descriptive analysis and interrupted times series analysis using segmented regression models were adopted to analyze the influence of the two reforms on medical expense and its structure. We also studied the impact mechanism of service utilization and service price factors on medical expense control.Results:During the period from 2016 to 2019, the medical expenditure of public medical institutions in Beijing increased steadily at an annual growth rate of 4.4%-7.2%. The proportion of drug expense decreased from 44.6% in 2016 to 34.6% in 2019, while the proportion of medical service expense rose from 15.6% in 2016 to 24.3% in 2019, the proportion of examination and laboratory test expenses respectively showed a significant decline in April 2017 and June 2019. These two months witnessed respectively the launch of the two comprehensive reforms. Service utilization played an important role in controlling outpatient and emergency expenses, and service price was the key factor for controlling inpatient expenditure.Conclusions:The implementation of the two reforms in Beijing has effectively curbed the unreasonable growth of medical expenditure, and the expense structure has been constantly optimized and labor value of medical staff gradually improved.
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Objective To find out the present pediatrician allocation and the burden of diagnosis and treatment in Beijing,so as to provide evidence for effective allocation of pediatricians.Methods Data and indicators were selected from Beijing Health Comprehensive Statistical Information Platform,including Manpower Basic Information Survey of Beijing Health Institutions,Annual Report of Medical Institutions,Beijing Statistical Data on Health Work (Compendium),as well as Beijing Health and Family Planning Statistical Yearbook.The study dynamically analyzed the number of pediatricians,that of pediatricians per 1 000 children,that of outpatients and emergency patients per pediatrician and the number of discharges per pediatrician from 2013 to 2017.Descriptive analysis was carried out on the data.Results In 2017,the proportion of pediatricians accounted for 2.78％ of the total number of doctors in the city,the number of pediatric emergencies accounted for 6.47％ of the total outpatients and emergencies in the city,and the number of hospitalizations accounted for 5.70％ of the total discharge in the city.From 2013 to 2017,the number of outpatients and emergency patients per pediatrician increased by 40.58％,and the number of discharged patients increased by 36.70％.The proportion of hospitalization at tertiary hospitals increased from 80.2％ to 85.1％,and that in primary institutions decreased from 6.3％ to 1.7％.Conclusions The study found such setbacks in the allocation of pediatric medical resources in Beijing,as insufficient pediatricians,unreasonable allocation and excessive burden on pediatricians.We should strengthen the planning and construction of pediatric human resources,improve the training mode of pediatricians,improve the salary level of pediatricians,and ease the burden on pediatricians,so as to provide high-quality medical services for children.
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Objective@#To find out the present pediatrician allocation and the burden of diagnosis and treatment in Beijing, so as to provide evidence for effective allocation of pediatricians.@*Methods@#Data and indicators were selected from Beijing Health Comprehensive Statistical Information Platform, including Manpower Basic Information Survey of Beijing Health Institutions, Annual Report of Medical Institutions, Beijing Statistical Data on Health Work(Compendium), as well as Beijing Health and Family Planning Statistical Yearbook. The study dynamically analyzed the number of pediatricians, that of pediatricians per 1 000 children, that of outpatients and emergency patients per pediatrician and the number of discharges per pediatrician from 2013 to 2017. Descriptive analysis was carried out on the data.@*Results@#In 2017, the proportion of pediatricians accounted for 2.78% of the total number of doctors in the city, the number of pediatric emergencies accounted for 6.47% of the total outpatients and emergencies in the city, and the number of hospitalizations accounted for 5.70% of the total discharge in the city.From 2013 to 2017, the number of outpatients and emergency patients per pediatrician increased by 40.58%, and the number of discharged patients increased by 36.70%. The proportion of hospitalization at tertiary hospitals increased from 80.2% to 85.1%, and that in primary institutions decreased from 6.3% to 1.7%.@*Conclusions@#The study found such setbacks in the allocation of pediatric medical resources in Beijing, as insufficient pediatricians, unreasonable allocation and excessive burden on pediatricians. We should strengthen the planning and construction of pediatric human resources, improve the training mode of pediatricians, improve the salary level of pediatricians, and ease the burden on pediatricians, so as to provide high-quality medical services for children.