ABSTRACT
Time-driven activity based costing is embraced in the healthcare sector for its correction of inherent defects of activity-based accounting. The authors constructed a two-level hierarchical cost accounting model for medical service items based on the time-driven ABC. The first-level hierarchical cost is calculated down to the department level in line with cost management regulations of the hospital financial system, while the second-level cost allocation is based on " time" as the basic sharing criterion, which is collected and assigned to specific medical service items with the activity content and process as carriers. The standard cost and actual cost of comparable medical service projects are calculated respectively by means of introducing the concept of socially necessary labor-time, which provides a scientific and feasible management method for evaluating the performance of medical service items.
ABSTRACT
Constructed in the paper is a theoretical model of the strategic procurement services by the government from macro, meso and micro level based on the concept of strategic procurement.The design comprised of a responsibility system, purchase mechanism and evaluation mechanism for the core operating mechanism of the government purchase of basic medical service.It aims to accelerate the reform of public hospitals in an effort to provide theoretical support and reference of the reform nationwide.
ABSTRACT
Objective To analyze the impact of performance-based contract management mode purchased by government on the equity and efficiency of public health services in rural areas.Methods Randomized controlled method,agency investigation and questionnaire survey on public health services recipients were used.Results The utilization of residents health records management services,child health management services,health care management of patients with hypertension and type 2 diabetes in pilot counties was higher quality absolutely fair.Gini＜0.2,CI≈0.The overall effectiveness,technical validity and effectiveness of scale of the townships in pilot counties were better than that in non-pilot county.Conclusion This management mode helps to improve the equity of public health services and service efficiency.
ABSTRACT
For the purpose of resolving such current problems as low inclusion ratio and high exit ratio in the single-disease clinical pathway management,the paper proposed an idea of clinical pathways grouping management,in line with DRG management and based on traditional clinical pathway management practice and China' s conditions.Proposed in the paper are such measures for government service procurement,as quality control mechanism,price negotiation mechanism,performance-based payment mechanism,and supervision mechanism.These measures are designed to provide incentives for medical institutions and medical workers,control irrational rise of medical expense,optimize expense makeup,and improve both quality of care and patient satisfaction.Thanks to the China Rural Health Development Project in place in Henan province where DRG-based clinical pathway grouping management and government service procurement are in trials,the following outcomes are achieved.Namely,significant expansion of diseases coverage and population coverage,efficient control of per-patient/per-visit expenses,and a steady rise of surgery and treatment expenses which embody value of service of medical workers.Other benefits include 50％ to less than 30％drop of drugs proportion,gradual optimization of medical expenses makeup,obvious improvement of quality of care.These measures have made hospitals,insurance providers and patients satisfactory.
ABSTRACT
This paper focus on the impact on the performance of health workers at village and township levels in the provision of a government stipulated package of basic public health service, which adopted the performance-related contracts mode. The concept of balanced scorecard was adopted and developed to gather the 11 evaluation indicators distributed in four quadrants. These were implemented using on-site questionnaire and interview design. Four thousand and twenty-one respondents at 30 administrative villages including 2674 respondents at 20 pilot villages and 1347 at 10 control villages were investigated. Meanwhile, 62 administration officials from three counties and nine townships were interviewed. Eight of 11 evaluation indicators were obviously better in pilot counties than in Control County, The remaining three indicators respectively represented that equal, inferior to control county, and could not clear judge. The performance of health workers at village and township levels in the provision of basic public health service in pilot counties, which adopted the performance-related contracts mode, is better than before and control county
ABSTRACT
This paper studied the development stages in terms of the public nature of public hospitals in China and analyzed the causes for their weakened public benefits.It proposed the principle of government guidance,achieving government purchasing of healthcare services as the roadmap,as well as building and improving the service purchasing system,performance appraisal system,and payment review system along with supervision system.These measures are designed to make public hospitals in their public benefit nature with scientific system design,powerful institutional guarantee,and efficient execution strategies.
ABSTRACT
An analysis of the fundamental concepts for public hospital reform further defined public hospitals and other hospitals,business and non-business in nature,public benefits and welfare,as well as public benefits and profit-oriented hospitals.These distinctions can help reformers of public hospitals clarify their concepts,make clear the purpose and direction of the public hospitals reform,so as to speed up the reform with theory support.