ABSTRACT
Objective To explore the differences in health care quality,scale,output,efficiency,cost and financial condition between freestanding secondary hospitals and system-affiliated secondary hospitals in Shanghai,and analyse the determinants of hospital integration. Methods Eleven upper secondary hospitals in Shanghai integrated between 2000 and 2004 were selected,and another 40 secondary hospitals (including 30 upper secondary hospitals and 10 middle secondary hospitals) without integration were served as controls. Using related data of 1999,Mann-Whitney U test was performed to analyse the differences between these two groups,and Logistic regression analysis was conducted to explore the determinants of hospital integration. Results There were significant differences in health care quality,scale,and output between these two groups (P0.05). It was revealed by Logistic regression analysis that health care quality,scale,output,and financial condition were determinants of integration. Conclusion System-affiliated secondary hospitals have advantages over freestanding hospitals in health care quality,scale,output and financial condition,and those with better health care quality,larger scale,larger output and better financial condition are more likely to be integrated by tertiary hospitals.
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Objective To study the effect of public hospitals vertical integration on scale economy in Shanghai. MethodsA total of 401 samples of 67 hospitals from 1999 to 2004 in Shanghai were collected.Median regression was performed to estimate the multi-output cost function and marginal cost of discharge patients,and scale economies were calculated.Results The independent variables Beds,W,X1,X23,Region,Level,Y03,and Y04 were all predictors of cost.Conclusion Both integrated tertiary and secondary hospitals had scale economy before and after integration.Integration enhanced the output and improved the efficiency of integrated secondary hospitals.To some extent,patients were dispersed to secondary hospitals.
ABSTRACT
In this paper, the SWOT analysis method is used to find out the internal strength, weakness, exterior opportunities and threats of the present medical devices' procurements in hospitals and some strategic considerations are suggested as "one direction, two expansions, three changes and four countermeasures".