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Objective:To build the evaluation index system of traditiond Chinese medicine(TCM) service capacity in county-level TCM hospitals, for references to improve the TCM service capability in China.Methods:Based on the " structure-process-result" evaluation model, a preliminary screening index system for the evaluation of TCM service capacity in county-level TCM hospitals was established by analyzing relevant literature and policies; Two rounds of Delphi expert consultation were made to screen the evaluation indexes; The combination weighting method based on both expert scoring method and entropy weight method was used to determine the index weight.Results:The evaluation index system of TCM service capacity of county-level TCM hospitals was finally incorporated into 3 first-level indicators, 9 second-level indicators and 33 third-level indicators. The top five third-level indicators in terms of comprehensive weight were the person time of TCM preventive care in the year(12.02%), the person time of manual reduction diagnosis and treatment(9.03%), the person time of acupuncture and moxibustion(6.55%), the proportion of income from inpatient TCM services in medical income(5.87%) and the person time of massage(5.34%).Conclusions:From the perspective of the whole process of TCM service, the evaluation index system of TCM service capacity of county-level TCM hospitals reflectd the health service capacity of county-level TCM hospitals, highlighted the characteristics of TCM.
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The issue on the acupuncture clinical service mode has been early proposed by the scholars. The acupuncture clinical service mode is still existed as the department of acupuncture in TCM hospital nowadays. But this pattern has brought the inconvenience and issues between physicians and patients. In the study, through reviewing briefly the history of acupuncture hospital since the foundation of the People's Republic of China, the authors explained why taking the Hospital of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences (CACMS) as the object. By integrating the relevant achievements of the scholars on the study of acupuncture hospital, the historical development of acupuncture-moxibustion hospital was reviewed. By comparing with the development mode of TCM hospital, the differences were generalized between the two hospitals in terms of the purpose of hospital establishment, the development mode of treatment, education and research, modernization mode, the relationship with western medicine and the hospital scale. It was analyzed by the authors that the development characteristics of acupuncture-moxibustion hospital were determined by the accidental and the inevitable factors. By the comprehensive analysis, the enlightenments to the future development of acupuncture-moxibustion hospital were explored.
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The paper presented the implementation of the healthcare reform policy and initial success of Xinyu TCM Hospital in its reform pilot work of public hospital reform in Xinyu city ,Jiangxi province. The authors also analyzed problems and causes of the hospital in business development and cost control during the reform ,proposing to carry out TCM development policy ,enhance government investment ,streamline TCM service pricing ,and innovate TCM supporting model. In addition ,they also proposed TCM hospitals to enhance management ,and reform their mechanism to resolve such problems as high operating costs ,and poor talent development and lack of feature disciplines .
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Objective • To discuss the health resources and service development of traditional Chinese medicine (TCM) hospitals in Shanghai from 2009 to 2016. Methods • Analysis of the health resources and service development of TCM hospitals in Shanghai from 2009 to 2016 were conducted by calculating composition ratios and growth rates according to the data from the statistical yearbooks. Results • All the indexes of the health resources and services of TCM hospitals in Shanghai, 2009-2016, increased every year, and the numbers of beds, medical technical personnel, licensed (assistant) doctors, registered nurses, outpatients and inpatients increased by 71.72%, 53.80%, 46.83%, 76.84%, 78.20%, and 120.30%, respectively. The proportions of TCM hospitals beds and health technicians in all the city's hospitals increased by 1.70% and 1.18% on the basis of 7.06% and 9.58%, respectively. The year-on-year growth rates of beds ranged from 1.86% to 22.52%, and rates of health technicians ranged from 0.17% to 15.46%. Daily visits each doctor and daily bed days each doctor in TCM hospitals increased by an average of 2.90% and 0.07% a year, respectively. Conclusion • There was a significant increase in health resources and service development of the TCM hospitals in Shanghai from 2009 to 2016, and the work efficiency were improved. And there was a little increase in the proportion of the relevant indexes in all the city's hospitals. However, some problems do exist, such as the weak integral strength and the unstable growth of TCM hospitals.
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The paper introduces the general thinking,methods and basic principles for study on the operating procedure of informatization work in Traditional Chinese Medicine (TCM) hospitals,and sets up the content frame including hardware system,software system,information security,relevant operation sheets,etc.,so as to supplement the.standards for informatization work in TCM hospitals at the operating level and provide support for secure,reliable and sustainable operation of information systems in TCM hospitals.
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Up to 2015, almost all of the Third-grade class-A TCM hospitals in Beijing set up multiple sub-hospitals, under the regional integrating of Beijing-Tianjin-Hebei region, in order to meet regional homogenization of medical and health care demand, to provide high-quality medical service for the patients, and to improve the hospital development in a certain stage. Taking Beijing university of traditional Chinese medicine affiliated Dongfang hospital for example, it creates "two sub-hospitals " a court layout of mode of "one hospital with multiple branches". This article analyzed the sub-hospitals organization structure reform, cost budget control, performance management & personnel training, information system construction, to draw lessons from practical manage experience, and explored the "multiple sub-hospitals " superior management mode for our hospital.
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Up to 2015, almost all of the Third-grade class-A TCM hospitals in Beijing set up multiple sub-hospitals, under the regional integrating of Beijing-Tianjin-Hebei region, in order to meet regional homogenization of medical and health care demand, to provide high-quality medical service for the patients, and to improve the hospital development in a certain stage. Taking Beijing university of traditional Chinese medicine affiliated Dongfang hospital for example, it creates "two sub-hospitals " a court layout of mode of "one hospital with multiple branches". This article analyzed the sub-hospitals organization structure reform, cost budget control, performance management & personnel training, information system construction, to draw lessons from practical manage experience, and explored the "multiple sub-hospitals " superior management mode for our hospital.
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OBJECTIVE:To provide reference to promote the proper use of TCM decoction pieces.METHODS:According to Beijing TCM Decoction Piece Dispensing Regulation,stratified random sampling method was adopted to select a group of physicians in our hospital and conduct questionnaire survey about their knowledge of the prescription handling of 8 commonly used TCM decoction pieces including Scutellaria baicalensis,Angelica sinensis,Fritillary,Phellodendron chinense,Aconitum carmichaeli,Eucommia ulmoides,Ziziphus jujuba,Rhei Radix et Rhizoma.Then,the survey data was collected and analyzed.RESULTS:A total of 81 questionnaires were given out and all were returned with effective recovery rate of 100％.In terms of professional titles,associate chief physicians showed the lowest average error rates in prescription handling cognition (27.5 ％),compared with physicians (35.8％) and attending doctors (37.0％).They made most mistakes about Fritillary and E.ulmoides.To the contrary,both physicians and attending doctors made most mistakes about E.ulmoides.In the scope of working life,physicians from different groups showed similar average error rates in prescription handing recognition (31.3％-38.8％).All of them made most mistakes about P.chinense and E.ulmoides.As for major,those who study western internal medicine shared larger average error rates (43.8％) than those who study internal medicine of TCM (36.8％),traumatology and orthopedics of TCM (31.8％) and acupuncture (36.5％).Each major showed the highest error rates in E.ulmoides.The order of 8 TCM decoction pieces from the most mistakes to the least mistakes made by physicians was E.ulmoides,P.chinense,Fritillary,Rhei Radix et Rhizoma,S.baicalensis,A.carmichaeli,Z.jujuba and A.sinensis.CONCLUSIONS:Physicians with different professional titles,working life and majors show deficiency in knowledge about the prescription handling of 8 commonly used TCM decoction pieces.Generally,physicians show the worst understanding of E.ulmoides.
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TCM hospital preparation, which is only used inside its own orgnations, is an important part of clinical medicine in TCM. In recent years, the lack of a corresponding constitution of legal safeguard seriously hampered the prosperities of TCM hospital preparations. It's a high time to settle a targeted legal safeguard constitution of TCM preparations developed by the hospital. The author takes hospital of TCM preparation as the research object, starting from the current situation and problems of development of hospital of TCM to dig out the reasons. It has great significance to ensure the status of TCM preparation developed by the hospital at first, to combine with other measures. and to put forward about the establishment of comprehensive legal safeguard mechanism for the development TCM hospital preparation.
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Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.
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OBJECTIVE:To provide reference for the development of hospital preparation in our hospital. METHODS:The method of SWOT analysis was applied to analyze competitive strengths,weaknesses,opportunities and challenge about the develop-ment of pharmaceutical preparations in our hospital,and to explore the development strategies of hospital preparation. RESULTS &CONCLUSIONS:The strengths include the prominent specialty characteristics of clinical key subject,a long R&D history,diverse dosage forms and varieties,definite therapeutic efficacy,etc. The weaknesses contain production capacity shrinkage,deficient con-struction of professional team,external exchange and cooperation deficiency,etc. The opportunities contain national health con-sciousness enhancement,hospital preparation included into local medical insurance reimbursement,etc. The threats contain great difficulty to register new preparation and low preparation pricing,etc. It is suggested to rely on advantage resources to enhance clin-ical formulation development,strengthen human resource management and team building,strengthen cooperation and exchanges to enhance research and development,strengthen the meticulous management to improve operational capacity,in order to formulate scientific development strategy.
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As a treasure of the traditional culture of China, TCM can be developed in long-term, that need the inheritance and innovation of scholars. During the process, it is an important responsibility and obligation that the development of TCM hospital. The development and improve of the hospital scientific research are important aspects for the development of hospital. The construction of scientific research team is an important approach to promote the hospital scientific research strength. By analyzing the whole current situation of hospital scientific research team, we will discuss the measures to strengthen the construction of hospital scientific research team from several aspects. These aspects include the system of scientific research team, talented person echelon structure, management system and the team overall strength, etc. These measures are aimed to strengthen the team construction characteristics of TCM, promote the scientific research level of TCM, contribute to the development of the career and hospital.
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In recent years, the incidence of diabetes has been increasing year by year. Along with it, the problems of high medical cost and health resource shortage also make the diabetes the key chronic disease of health service management in our country. There are significant features and advantages in treatment of diabetes with traditional Chinese medicine. Therefore, the construction mode of two-way referral care for diabetes patients between TCM hospitals and community medical institutions is just unfolding. Based on the status quo of TCM treatment for diabetes, this article reviewed the present basic situation of the two-way referral care for diabetes patients in TCM hospitals and community medical institutions, discussed the significance of this mode for diabetes patients in TCM hospital, emphasized the feasibility and validity of implementing this mode, and provided beneficial exploration and consideration for further development of this mode for diabetes patients between TCM hospitals and community medical institutions.
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ObjectiveTo study the present human resources of TCM hospitals in China, for decision making of TCM hospitals HR strategy in the future. Methods Collection of statistics released by the Ministry of Health and the State Administration of Traditional Chinese Medicine from 2005 to 2009, for analysis of the general structure and trends of hospital staff at large, headcount and makeup of medical personnel, and the structure and trends of TCM professionals in TCM hospitals. Results In 2009, there were 2,728 TCM hospitals, employing 518, 5000 staff, including 427, 900 medical personnel, accounting for 82.52％ of the total; TCM practitioners account for 45. 61％ of clinicians in TCM hospitals;a shortage of nursesisfoundin TCM hospitals as comparedto general hospitals. ConclusionIt is imperative to revise the staff quota standard of TCM hospitals, and to increase the number of TCM practitioners and nursing staff in TCM hospitals.
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Objective To establish a framework of indexes for assessing the composite results in TCM hospitals so as to promote their development. Methods Such methods and techniques as literature review, descriptive study, Delphi expert consultation, step analysis, composite index, weighted rank sum ratio, and correlation analysis as used by Kendall and others were adopted. Results The current situation regarding the allocation and utilization of health resources in a certain city was found out and a framework of indexes for assessing the composite results in TCM hospitals and the demarcation line for dividing the results into grades were defined. Conclusion The development of TCM hospitals in the city has reached a certain scale, the feature of TCM specialties forms a new growth point, and the framework of indexes for the assessment of composite results in TCM hospitals needs constant perfection.
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Objective To control medical expenses in a rational and effective way by analyzing the main factors influencing hospitalization expenses in TCM hospitals. Methods Based on ICD 10 codes, the top 50 disease entities causing hospitalization, as had been accumulated over the years, were extracted from the hospitalization record data warehouses of the national TCM supervision networks using nationally representative medical record databases, the main factors influencing hospitalization expenses were identified using multi layer BP neural network, and further analyses were made by disease entities and hospital grades. Results When disease entity mix analyses were conducted, it was found that the variables most influencing hospitalization expenses/days were hospital code and disease entity while variables specific to TCM had little influence on the expenses. The results were also true of analyses made by hospital grades and disease entities. Conclusion Under the current circumstances in China, the influence on hospitalization expenses resulting from the difference between hospitals is far greater than any other factor; it is even greater than that resulting from the difference between disease entities. It is therefore imperative to pay attention to the extensiveness and coverage of data sources when conducting research on the control of medical expenses.
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Objective To analyze the present situation of technical efficiency in TCM hospitals throughout the country, discuss the influencing factors causing inefficiency and propose corresponding suggestions. Methods The technical efficiency in 60 TCM hospitals in the country was analyzed using the stochastic frontier cost model for panel data and the influencing factors causing inefficiency were discussed using the multiple stepwise regression method. Results The average technical inefficiency was 22.59% and inefficiency showed an upward trend as the areas shifted from the eastern through the middle to the western regions. Five factors, including the utility rate of beds and the proportion of health technicians among the entire hospital staff, were statistically significant so far as the effect on the increase of the overall cost was concerned. Conclusion The stochastic frontier cost model for panel data is the best method for evaluating the technical efficiency in TCM hospitals. On the basis of the above analysis, suggestions for strengthening scientific management, improving the utility rate of resources and reducing unnecessary waste are put forward.