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Secondary hospitals play a pivotal role and serve as a link in the medical service system in China. However, at present, large general hospitals are still siphoning down resources, primary medical institutions are developing rapidly, and private medical institutions join the medical market competition. In this case, to survive and develop, the secondary hospitals should choose corresponding policies and measures according to the characteristics of each region, such as, the secondary hospitals in remote and backward county should reduce medical expenses, increase reimbursement ratio and strengthen financial compensation, urban secondary hospitals with mature conditions should strengthen the function of medical and nursing care or transform and upgrade to tertiary hospitals or integrate into the medical consortiums.
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Objective To explore the financial compensation strategy on the basis of understanding the current situation of compensation for public health services at public hospitals in Zhejiang province.Methods From July to October,2017,an interview survey was conducted at 23 public hospitals in 7 cities in Zhejiang province to understand the current situation of financial compensation for public health services at public hospitals.At the same time,the data of income and expenditure in 2016 of every hospital were collected and analyzed by the methods of descriptive statistics.Results The average proportion of financial subsidies at the 23 public hospitals in 2016 was 6.29％,of which public health special subsidy accounted for 0.44％ of total hospital revenues.Only 9 of the 23 hospitals had surplus in 2016,accounting for 39.13％.Conclusions The public health services compensation mechanism of public hospitals in Zhejiang province calls for further reforms.The government departments should comprehensively formulate financial compensation policies at the provincial level according to the public health assignments and call into play a variety of compensation methods,to establish a long-term assessment mechanism and ensure that public hospitals can proactively carry out public health services.
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BACKGROUND: We investigated the impact of financial compensation on patients' decision of participation in clinical trials and the related factors with patients' attitudes and considerations. METHODS: A survey questionnaire was placed from October 31 to November 16, 2017 to the subjects who were enrolled in the trials of chronic diseases. Patients' socio-demographic characteristics were collected and the potential reasons for participating in the trials were assessed using 5-likert scores. RESULTS: Sixty eight of 110 respondents (61.8%) indicated to participate clinical trials regardless of financial compensation. The differences were found between patients who were unwilling to participate without compensation and those who were willing to participate regardless of compensation in mean ages (43.9 years vs. 52.0 years, p<0.05), marital status (married, 47.6% vs 79.4%, p<0.01), religions (yes, 45.2% vs 67.6%, p<0.05) and monthly income (≥3 million won, 19.0% vs 45.6%, p<0.01). The potential reasons for participation in the trials between two groups were doctor's suggestion (52.4% vs. 77.9%, p<0.01), the expectation of health improvement (54.8% vs. 73.5%, p<0.05), the types and numbers of procedure (33.3% vs. 16.2%, p<0.05) and the duration of clinical trials (59.5% vs. 27.9%, p=0.001). In regression analysis, the monthly income of ≥ 3 million won (odd ratio, OR=3.221, p=0.026,) and the duration of trials (OR=0.290, p=0.017) were related to the group with the willingness to participate regardless of compensation. CONCLUSION: This stady showed that more than half of study subjects would participate in the clinical trials of chronic diseases regardless of financial compensation.
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Humans , Chronic Disease , Compensation and Redress , Marital Status , Surveys and QuestionnairesABSTRACT
Objective To investigate the attitudes of medical students regarding to organ donation compensation.Method A self administered questionnaire was distributed to 600 medical students selected randomly from two medical universities in China between January 2013 and January 2014.The questionnaire included demographics and core questions related to medical student's attitudes regarding organ donation compensation.Result A total of 600 questionnaires were distributed and 592 valid responses were received,including 150 doctoral students,143 master students and 299 undergraduate students.In all,69.8％ of medical students believed that compensation for organ donor was essential.Nearly 60.5 ％ believed financial compensation would increase the rate of organ donation but would not tarnish the behavior of organ donors (64.7％).At the same time,over 70％ of medical students believed that financial compensation would increase the number of living organ donation.With regarding to the ways of compensation,most of the students (80.4％) were in favor of priority on waiting list.Reducing or free of hospitalization costs (50.4％) and increasing the reimbursement ratio of medical insurance (41.8％) were also the acceptable compensation ways to medical students.Conclusion Most of medical students believe that it is essential to give compensation to organ donors.Enjoying the priority on waiting list,reducing or free of hospitalization costs and increasing the reimbursement ratio of medical insurance are the reasonable incentive methods.
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To cement the 5 years’ staged achievement of new medical reform so as finally achieve the objective of medical reform, public hospital would become the aim of reform in the following stage. On one hand , canceling “using drug to supple health care” in public hospitals has came into the crucial stage; on the other hand, the government needed to increase financial input and ensure the implementation of security fund. What was the relation between these two reforms? Therefore , based on the survey of county-level public hospitals in G Province, relationship among government compensation method, hospital public profit operation mechanism and profit-driven operation mechanism were analyzed; besides, different financial insurance mode had different operation efficiency. Because the construction of hospital expense under public profit operation mechanism was more reasonable , the required government insurance fund was less, which only accounted 32.9%of the required fund under the profit-driven operation mechanism. Therefore, the policy suggestions that government need to “buy the mechanism” and “be brave to implement ‘subtraction reform’” were proposed.