ABSTRACT
Objective To learn the business operations of the pilot county-level public hospitals chosen for the 2014 experiment,which were subsidized at different levels in the financial subsidy mechanism reform.Methods County-level public hospitals from 109 counties were sampled as pilots from two provinces of the eastern,central and western regions of China.Descriptive analysis and correlation analysis were made to study their business operations at various subsidy levels.Results Proportional differences in the governmental financial subsidy level make a difference in the revenue and expenditure of county-level public hospitals.The higher the subsidy proportion,the lower the annual average of the total workload of the hospital(P <0.01),the less the inpatient expenditure per hospitalization(P =0.01),and the lower the drug proportion as well(P <0.01 ).Conclusions Financial subsidy plays a key role in the financial balance and business operation of such hospitals.Hence the government is proposed to guarantee its financial subsidy responsibility,to build a long-term financial subsidy mechanism.
ABSTRACT
Objective: To analyze the current situation and problems of primary health care personnel since the new round of China's health care reform, and to provide a reference for stabilizing the primary health care personnel. Methods: This paper uses descriptive statistical analysis to calculate Gini coefficient and Theil index in order to ana-lyze the equity in headcount, structure and distribution of primary health care personnel among all health care institu-tions nationwide. Results: Between 2008 and 2013, the number of primary health care personnel significantly in-creased and their quality was improved. Moreover, although the Gini coefficient and Theil index of primary health care personnel continuously decreased in China's eastern, central and western provinces the difference inside the east-ern China is the main factor affecting the overall difference. Conclusions:Not only the problems of insufficient num-ber and loss of personnel still coexist in the primary health care personnel in China, but also there are other issues such as the structural imbalance of professional titles is especially prominent, the urban-rural and regional gaps are still large, etc. The main reasons for these issues are related to the irrational incentive mechanism, the inefficiency of the synergistic effects of administrative staffing policy and some reform measures, etc. This paper suggests further re-forming the income distribution system and improving primary governance capability in order to strengthen the policies to synergically attract and stabilize primary healthcare personnel.
ABSTRACT
This paper compared the practice and service mode of general practitioners ( GPs) from a selection of typical countries and regions and discovered that GPs from most of the countries were self-employed, with various forms of employment, freedom to practice and work in different institutions;fixed practices were supplemented, and service types were transformed from individual services to the multi-disciplinary team of services. Result: GPs’ free-dom to practice in different institutions requires a certain social environment and circumstances. The multi-disciplina-ry team of practices has become the development direction for the service modes of GPs. GPs have played different roles in establishing the referral system in the health systems of different countries. Consequently, the paper suggests that establishing a diverse and relaxed practice environment to provide conditions for the transformation of the service mode of GPs. The construction of a multi-disciplinary team to promote changes in community service modes was must be strengthened. Health insurance regulations should be encouraged to establish the gatekeeper system and realize a grading of systems. Social capital should be encouraged to organize general medical services to promote the develop-ment of the health care industry.