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Objective:To investigate the status and willingness of information disclosure based on social supervision in tertiary and secondary public hospitals, so as to provide reference for expanding information disclosure content.Methods:By using stratified cluster random sampling method, 66 tertiary public hospitals and 126 secondary public hospitals in 6 provinces were selected for questionnaire survey in April 2021. Thirty-one indicators in 3 categories and 5 groups were selected to obtain the information disclosure status and willingness. Chi-square test, variance analysis and paired t-test were used to conduct difference analysis. Results:The indicators with higher disclosure rates in public hospitals were drug prices and medical service price adjustments (93.9% in tertiary hospitals and 92.1% in secondary hospitals) and medical insurance reimbursement policies and compensation processes (90.9% in tertiary hospitals and 86.5% in secondary hospitals), while the indicators with lower disclosure rates were case fatality rates in low-risk groups (24.2% in tertiary hospitals and 26.2% in secondary hospitals), proportion of special needs medical services (27.3% in tertiary hospitals), and average daily outpatient visits per practitioner (27.3% in tertiary hospitals and 26.2% in secondary hospitals). The indicators that public hospitals thought could be disclosed at a higher rate were drug and medical service price adjustments, medical insurance reimbursement policies and compensation processes, and prices and medical insurance reimbursement of commonly used drugs and major medical consumables, while the indicators that were thought to be disclosed at a lower rate were some medical service safety indicators and hospital financial indicators.For all indicators, the percentage that the hospitals thought could be disclosed was higher than the percentage that had been disclosed.Conclusions:At present, China′s secondary and tertiary public hospitals have a low rate of disclosure about medical service efficiency, medical service safety, statistical summary cost and financial indicators. However, except for some medical service indicators and financial related indicators, the hospitals′ information disclosure willingness is relatively high, and the scope of information disclosure can be expanded in an orderly manner in steps.
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The reform of public medical institutions is a critical and difficult breakthrough in furthering the healthcare system reform in China, for which the performance appraisal of public hospitals can serve an important role. The performance policy documents of tertiary public hospitals, secondary public hospitals and primary medical and health institutions in China since 2019 were compared and analyzed, to systematically identify the similarities and differences and development rules of the three evaluation index systems. The study analyzed the impacts of the three systems on the management of medical institutions and provided reference suggestions for improving their performance evaluation. It was found that all the three systems aim at guiding tertiary public hospitals to evolve from the pattern centering on scale expansion to that on quality and benefits, guiding secondary ones to improve their capacity of medical services, and guiding primary medical institutions to focus on basic medical and public health services. However, these systems lack indexes on hierarchical diagnosis and treatment for secondary hospitals and application of examination results, while national surveillance indexes on primary ones accounted for only 23.8% of all. It is recommended to dynamically adjust both the performance evaluation index system and the surveillance methods, and to enhance the application of examination results and development of supporting policies as well.
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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 investigate the compassion fatigue and stress status and the relationship between them of nurses working in secondary hospitals of integrated areas of urban and rural places, and explore the social factors that influence the compassion fatigue and stress status. Methods 378 nurses from secondary hospitals in urban-rural integrated area were selected as samples in Nanjing. Paramedic′s Compassion Fatigue Scale and Chinese Nurse Stressor Questionnaire were adopted to develop the survey. Results The nurse compassion fatigue score was (15.9 ± 1.83) points; Stress status score was (86.18 ± 19.96) points. Urban-rural fringe secondary hospital nurse compassion fatigue status was positively associated with the pressure (r=0.218, P<0.01), and loss of enthusiasm, nervousness, loss of ability to doubt, and morale were on the medical staff work pressure had significant influence (P<0.05). Conclusions The nurse compassion fatigue and stress level were in the medium level; Nursing managers should pay more attention to the psychological health level of the nurses, increase nurses' enthusiasm, alleviate the occupational stress of nurses caused by compassion fatigue.
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As an important part of the hierarchical medical system in China ,urban secondary hospitals play as a pivot between tertiary hospitals and community healthcare centers.By describing the overall development status of such hospitals in China ,the paper discussed the problems existing in the development of urban secondary hospitals and put forward strategies in the hope of providing reference for the transformation of these hospitals .
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This paper made systematic description of the three objectives of sustainable development designed for the policy based on the sustainability theory for the health sector.The essential drug system for secondary hospitals comprises the list coverage and allocation percentage of essential drugs,requirements for bidding and purchasing as well as pricing practice; management and conditions of these hospitals,including leadership determination and competency,doctors prescription behavior,and supportive reforms at these hospitals; external policies and social environment,including government financial subsidy,medical service prices adjustment,medical insurance,and the awareness and attitude of the people on essential drugs.
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Objective To study and contruct competency characteristic evaluation models of nursing supervisors in secondly hospitals.Methods Using the matron semi-structured interviews,literature review,questionnaire survey and expert questionnaires to discuss the competency of nursing supervisors in secodary hospitals.Results We found that the competency model of nursing supervisors in secondary hospitals could better reflect the competency of nursing supervisors.The model had 16 competencies which included knewleage skills.management and individual characters.Conclusions Through the study of the model of competency nursing supervisors in secondary hospitals,we form a set of standard for nursing supervisor selection based on their competency.The standard can help to select the most suited nursing supervisors who have great potentials.