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Objective:To evaluate the ophthalmic service ability of county hospitals in China based on the improved DS evidence theory.Methods:Convenient sampling method was used to select the data of ophthalmology department of 9 county hospitals in eastern, central and Western China in 2019. The improved DS evidence theory method based on Mahalanobis distance weight coefficient was applied to evaluate the medical service ability, and the evaluation results were compared with the classical evidence theory method.Results:The regional development of ophthalmic service capacity in counties of China was uneven, and there were regional differences in the evaluation results of some indicators. Hospitals in the eastern region were generally leading in the evaluation of a number of indicators related to the amount of medical services. The numbers of inpatient operations, outpatient operations, bed turnover times, bed utilization rate, number of inpatients, number of outpatients, number of patients in the eastern region were 3.25, 1.60, 1.81, 1.61, 2.64, 2.63 and 4.47 times of the numbers of hospitals in western region. Compared with the classical evidence theory method, the analysis results of the improved DS evidence theory method were consistent with the actual business development of each hospital, and the evaluation results were credible, which could more effectively reduce the uncertainty in the evaluation results.Conclusions:Ophthalmic service ability of county hospitals in China needs to be continuously improved. Improved DS evidence theory can be adopted to make continuous evaluation.
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Progress of the DRGs payment reform is raising higher demands on coders'competence at county-level hospitals. These coders at present are mostly transferred from nurses or medical technicians, who tend to be older in age and lower in education and academic title. To improve their competence, it is imperative to promote coders cultivation in terms of regular career needs, self-determination theory and performance management. Coder ranks deserve attention to build professional and outstanding coders.
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Objective To analyze and compare the capacity and efficiency of county-level hospitals′medical service by using the diagnosis related groups ( DRGs ) method. Methods The homepage data of discharged inpatients from seven county-level hospitals in Wenzhou region in 2013 - 2015 period were analyzed, for measurement of the medical service capacity changes of such hospitals using the number of DRGs, total multiplicity of weight, and CMI value, and that of their medical service efficiency changes using expense consumption index and time consumption index. Results The study found in the seven hospitals 8. 49% increase of the total number of DRGs, 17. 34% increase of total multiplicity of weight, and 5. 06%increase of CMI value, with unchanged expense consumption index and 9. 82% decrease of the time consumption index. These facts evidenced enhancements of these hospitals in both service capacity and service efficiency in general. Conclusions DRGs as tools prove useful objectively and scientifically. Policies of Two emphases at primary ends and two enhancements have been implemented desirably.
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Objective:To evaluate the efficiency of high-tech medical equipment of county-level hospitals in Guangxi Zhuang Autonomous Region, and to provide a scientific foundation for high-tech medical equipment configuration planning for county-level hospitals.Methods: DEA model was used to evaluate the relative efficiency of 40 county-level hospitals in Guangxi.Results: 4 among 40 hospitals (10.00%) could be categorized as effective hospitals, and pure technical efficiency is not high in 30 hospitals (75.00%). The returns to scale decreased in 20 hospitals (50.00%), and 16 hospitals (40.00%) increased. The average number of the overall efficiency, pure technical efficiency and scale efficiency of the 40 hospitals were 0.684, 0.753 and 0.908 respectively. Conclusion: Departments concerned should set reasonable evaluation index to ensure that the evaluation is scientific. Hospitals should strengthen the internal management of high-tech medical equipment to improve the utilization rate of the equipment. Departments concerned are supposed to curb or enlarge the number of the high-tech medical equipment to improve the scale efficiency of the equipment.
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Objective To build a clinical key disciplines evaluation index system for county level hospitals in Chengdu city.Methods Literature meta analysis, focus group discussion, expert consultation method, boundary value method, brainstorming and hierarchy analysis method were comprehensively used.Results The clinical key disciplines evaluation index system for county level hospitals in Chengdu city comprises 5 level-1 indexes,1 6 level-2 indexes,47 level-3 indexes.Among the level-1 indexes,service capacity,medical quality,technical personnel,scientific research and education, and foundation of specialty was 0.474 6,0.202 7,0.148 2,0.097 7,0.076 8 respectively.Conclusion The clinical key disciplines evaluation index system for county level hospitals in Chengdu city is scientific, guiding and practical,which can be used to evaluate the status of the clinical key disciplines for county level hospitals in Chengdu city.
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Objective To analyze the doctors' working enthusiasm and its influencing factors on county level hospitals.Methods 17 seminars were held in 8 counties of 3 provinces to investigate 1055 doctors with questionnaires, analyzing the three scales of working enthusiasm, working enthusiasm influencing factors, and changes since the 2009 new healthcare reform.Results Working enthusiasm comprises inner drive, working pleasure, work recognition and external recognition, and inner drive of which is found to play the most important part, with 20.55％ variance contribution.Among the six dimensions of the influencing factors, working conditions rank the highest with 19.46％ variance contribution.Conclusion Optimized measures in the healthcare reform, better working conditions and social environment can improve working enthusiasm of these doctors.