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To accelerate the development of talent team construction is the urgent issue in the county level public hospital. Introduction of high-level talents in a flexible manner to work in county level public hospital can promote the sustainable development of the hospital. In view of the reality of Binhai county people's hospital, the author analyzes the flexible recruitment, training, encouragement and management of talents, which helps promote the cultivation of medical personnel, enhance research capacity and medical technology.
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Objective To analyze the static and dynamic efficiency of the county-level public hospitals in Jiangsu province, and the influencing factors of efficiency. Methods The static and dynamic efficiency of 43 such hospitals was analyzed using the super-efficiency DEA and the Malmquist index method, and the influencing factors were studied using the Tobit regression model. Results Overall efficiency of the 43 county-level public hospitals varies significantly, mostly found in their technical efficiency. From 2014 to 2015, the total factor productivity index of some hospitals declined, mostly due to declining technical efficiency changing index. The efficiency is positively correlated to the location of the hospital, medical personnel, and the ratio of beds available. On the other hand, the efficiency is a negatively correlated to hospital grading, drug proportion per 100 yuan medical income. Conclusions Differential strategies are recommended to improve their operational efficiency, by optimizing hospital resource allocation, rationalizing hospital scale, and improving internal management system.
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Objective To provide reference for further promoting the development ability of county-level public hospitals by analyzing the influencing factors of the development ability of county-level public hospitals in Jiangsu Province from 2014 to 2016.Methods Different development indicators of 32 county-level public hospitals in Jiangsu Province were collected,and data were analyzed by Excel2007,and SPSS22.0 was used to analyze the comprehensive development ability of hospitals.Results Scale development factor,human resources development factor and medical service development factor have impacts on the development capacity of county public hospitals in Jiangsu Province.Different hospitals have different scores.on three factors,and their development ability is identical.Conclusion The scale of the hospital,the staff development and the medical service are important to the development of the count-level public hospitals.
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Based on literature review determining evaluation dimensionality,and with the relevant policies,the original index system is determined.Through using two rounds of focus group discussion and two rounds of expert consultation method,a set of county hospitals comprehensive reform of index system,which consists of 3 primary,14 secondary indicators and 64 tertiary indexes,is established.The analytic hierarchy process is used to determine the weight of evaluation index.At the same time,the reliability and validity of index system are tested.This proves that the established evaluation index system can give scientific and reasonable assessment results for comprehensive reform of county-level hospitals.
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It is an important content for breaking the mechanism ofdrug-supplement-medicine that the com-pensation system of drug zero price rate should be improved in public hospitals. In this paper, we collect random sampling survey data of the implementation of zero-difference drug sales before and after which is performed in People's hospital and Traditional Chinese Medicine hospital in five counties( districts) of Chongqing city. Based on the data, the status and effects of pharmaceutical service Fee policy on the county-level public hospitals in Chongqing was evaluated by combining quantitative description with qualitative analysis in the research methods. The study shows that the compensation policy design of pharmaceutical service fee is reasonable in Chongqing city and its posi-tive effect is obvious. It has also an obvious effect on the reduction of the average outpatient and hospitalization drug expense;but it's not conducive to arouse the enthusiasm of public hospital deepening reform of the initiative because the actual compensation rate of pharmaceutical service fee is low, and the public hospital comprehensive compensa-tion mechanism and operation mechanism reform are lagging behind.
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In order to solve the drawbacks of egalitarianism,induced demand and ineffective incentive in the current distribution mode,the leverage of the salary mobilization and the hospital development is used to put forward the relative value of RBRVS as the theoretical guide to accounting the medical service project,and to establish doctor post value and comprehensive goal assessment system.Finally,a salary distribution model for doctors in county-level hospitals based on doctors' workload post value and comprehensive goals assessment will be formatted,which will reflect public welfare and incentive mechanism.
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Objective To propose on reform and development policies of county-level public hospitals in Beijing by means of investigation and analysis of their business operations to identify existing problems.Methods Quantitative,descriptive analysis and in-depth interviews were used to study business operation data from 2012 to 2014 of the 30 county-level public hospitals in Beijing,in order to learn their development trends.Results Business operations of such hospitals were found to be desirable in general.The average growth rate per annum of the revenue of county-level hospitals,traditional Chinese medicine hospitals and women-children health hospitals was 1 5.7%, 18.7%,and 1 1.0%respectively; such growth rate of their expenditure was 1 6.4%, 21.1%, and 1 5.1%respectively.Roadblocks were also found,however,namely low income of medical personnels,operations in debt,lack of subsidy channels,and the marked gap of development among such hospitals.Conclusions In view of the above-mentioned problems,the authors put forward policy suggestions as follows:to optimize the government subsidy mechanism,to improve financial supervision and internal audit of such hospitals,to reasonably raise income of the medical personnels,and to build a mutually complementary system of medical service system that is mutually complementary between urban and rural areas in terms of their functionality.
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Literature review to build optional indexes pool,Delphi method to screen indexes,fuzzy model used to calculate the weight,for building such a system.An index system centering on public wellbeing is thus constructed,comprising three level 1 indicators,six level 2 indicators,40 level-3 indicators.The system can satisfactorily reflect the vision of county-level public hospitals reform,and showcase outcomes of such a reform.
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Based on the organization and implementation of the comprehensive reform of countylevel public hospitals in 15 provinces (municipalities)in southern China,the research discussed the progress and problems of such reforr.The progress made and areas of the reform vary among provinces and municipalities.For example,the reform has completely covered all the counties in four provinces such as Zhejiang and Jiangsu province.Medicine markups have been canceled in all the pilot counties by adjusting the service prices to pave the way for hospital compensation.Contemporary hospital management,remuneration system and personnel system reform are also main targets of the reform,while the collaboration between superiors and subordinates,and hospital regulatory system have recently been included.Problems are also found with the current reform:for example,lack of attention for the system reform,no fundamental changes in place in the business orientation of hospitals,as well as problems in collaboration among departments,and hospital debts.
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Covered in the paper are the policies and progress of the county-level public hospital reform in the province,and a summarized analysis of the self-appraisal reports and hospital reform statements submitted by the health authorities and up to 300 hospitals in 79 counties of the province.As found in the papers,the ongoing reform in Zhejiang is focused on reforming the business models in place,seeking breakthroughs from the zero mark-up policy on drug sales,in addition to such policies as reducing drug costs,adjusting medical service pricing,financial subsidies,and medical insurance payment reforms.Despite the initial success,further policy studies are needed in terms of internal management,upper and lower linkage,and personnel incentives.
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Objective: As the breakthrough for public hospital reform in China, County public hospital comprehensive reform has become the main part of the reform, the reasonable use of New Rural Cooperative Medical System(NCMS) would strongly push the process of new medical reform. Methods: The method of mathematical modeling was applied in policy imitate of hospital operation historical data, to estimate the increasing of decreasing status of NCMS hospital compensation expenditure after the implementation of county-level public hospital comprehensive reform measurement in 10 county-level public hospital. Results: Through analyzing the operation data of applying county-level public hospital comprehensive reform measurement in 10 county-level public hospital from 2010 to 2012, there was 66.67% annual time, the NCMS compensation expenditure for public hospitals increased to 23.075 6 million yuan, which increased by 1.691 7 yuan averagely. Conclusion: After the implementation of comprehensive reform policies, the influencing factors of NCMS funds on the decreasing degree of county-level public hospital expenditure were mainly the proportion of pre drug addition ratio and basic drug sales in the total drug sales.
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This paper presented the practice of Zhejiang in introducing the drug zero-profit reform.A comparative analysis was made to the pilot county hospitals regarding their business performance,patients' burden,financial subsidy and medical insurance expenditure.The reform has scored a success as expected with the following outcomes:sharp rise in medical services volume,medical income and financial aid on one hand; drop of the proportion of drug income and changes in the medical income makeup; controlled increase of average cost of outpatient and inpatient care,and significant drop of pharmaceutical costs; increased expenditure yet stable operation of medical insurance funds;proportional increase of medical insurance compensation,with drops of the proportion of both out-ofpocket expenses and visits to doctors out of their county.This reform,however,has such shortcomings as follows:insufficient adjustment toward true costs of medical services,lack of a clear and sustainable financial compensation mechanism,and that of supporting measures.Based on these,the authors call for accelerated payment system reform,dynamic and scientific adjustment of medical service prices,exploration of clear financial compensation methods,optimization of internal management of hospitals,and acceleration of the formation of a medical staff income distribution mechanism.
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The drug zero-profit reform in place has changed the compensation channels for China's public hospitals at the county level.In view of this situation,the paper probed into the present landscape of the compensation mechanism at such hospitals.The authors analyzed five compensation channels,i.e.,the special government budget subsidy,adjustment of medical service charges and rates,health insurance payment,social financing,and income/expenditure management.The study aimed at providing policy proposals and references for sustainable reform at such hospitals.