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Objective:To study the willingness of the medical staff of tertiary hospitals to be dispatched to work for a long time at the district hospitals under the " municipal trusteeship of district-ownership hospitals" mode, and explore the key factors that affect their long-term willingness, for references of optimizing the incentive system of the model.Methods:A questionnaire was designed as guided by the two-factor theory. In May 2019, a typical sample survey was made to investigate 103 medical staff of two tertiary hospitals in Beijing on their willingness to be dispatched to hospitals of district ownership. The survey covered such aspects as their basic personal information, hygiene factors(family responsibility, interpersonal connections expansion, mobilization and encouragement of leaders, etc.), and incentive factors(personal career development, greater potential giving play to their own talents, self-achievement, etc.). Descriptive analysis and univariate hypothesis testing were used to compare the differences of the dispatch willingness of staff of different characteristics. Meanwhile, an ordinal multinomial logistic regression model was built to analyze the influence factors of long-term dispatch willingness of these staff along with individual in-depth interviews.Results:The medical staff when they were dispatched to work at the entrusted hospitals for a long time, were concerned mostly with top six factors. These factors refered to a reasonable incentive(rewards)mechanism, family responsibility, colleague evaluation of the entrusted hospital, interpersonal connections expansion, personal career development, and potential unlocking. Those staff with dispatch experience had higher willingness to be dispatched than those without( P <0.05). The former saw higher of their personal career development resulting from the dispatch(3.91 points), while the latter saw higher their post-dispatch salary incentive mechanism(3.95 points). Compared with common medical staff, medium and high level management staff were more willing to be dispatched for a long time( H=14.536, P<0.001). Leadership mobilization in hygiene factors and personal career development in incentives factors were the key drivers for the long-term willingness of medical staff to be dispatched( P<0.05). Conclusions:The willingness of medical staff to be dispatched for a long time needs to be strengthened in the " municipal trusteeship of district-ownership hospitals" mode. Managers of the district-ownership hospitals should take into full consideration, the needs of different categories and levels of medical staff dispatched, guarantee the remuneration and performance pay of these staff, and enable their career track planning, hence mobilizing their incentives, and increase their willingness to work at such hospitals for a long time.
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Objective:The construction of public medical group is an important strategic measure to deepen the health reform in China. Taking Beijing Traditional Chinese Medicine Hospital as an example, the article introduces the measures, achievements, existing problems and possible development direction of the discipline co-construction in the entrusted district hospital.Methods:The article analyzes the measures of discipline co-construction and its implementation effect in detail.Results:It has effectively promoted the reasonable allocation of resources between " well-developed leading disciplines" and " disciplines to be nurtured" in the medical group, these disciplines entering a new rapid development phase through optimized organization and management, system construction, new research platform construction.Conclusions:" Disciplines to be nurtured" has been improved in medical service, scientific research capabilities, talent training, academic inheritance and quality of scientific research achievements, based on which, the goal of promoting the development of medical group through discipline co-construction was achieved.
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This paper introduced the development of medical specialists alliance in Zhejiang University. With Jinhua Central Hospital as an example,merits and setbacks of the 3-level trusteeship model in practice were discussed,with improvement recommendations raised for progress of the hierarchical medical system.
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The combination of field surveys and field interviews were conducted in Beijing Shunyi district Traditional Chinese medicine (TCM) hospital to investigate the work situation and find the effectiveness and the existing problems of the hospital after accepting the unified management, technical support, talent support, teaching and scientific research support from a 3As hospital. After trusteeship, the business volume of Shunyi District TCM hospital has increased,the level of scientific research and education have improved,and the service capacity of traditional Chinese medicine has been enhanced. But it is necessary to coordinate trusteeship funds, clear responsibility and power, strengthen the construction of hospital informatization, unified the use of hospital preparations and to improve the hospital trusteeship model.
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Objective:To explore the rational mode of hospital management under the trusteeship mode through the case study of a county-level hospital entrusted by a large general public hospital.Methods:Based on the system construction,the complete sinking of quality medical resources,the cultivation of talents and cultural integration,this paper analyzed the current situation of medical technology and service quality in hospitals before and after trusteeship by a retrospective control study.Results:The medical technology,quality and patient satisfaction of the hospital were improved significantly after trusteeship.Conclusions:The effective measures in the process of trusteeship of county-level hospitals are conducive to improve the level of medical technology and service of county -level hospitals,which can ensure the quality and safety of medical treatment,provide valuable suggestions for decision-making,and promote the development of hierarchical diagnosis and treatment.
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That provincial hospital hosting the local hospital is an important measure to deepening the reform of medical and health system.Advanced hospital management mechanism and excellent technical experts were gradually introduced into the local hospital to establish South Hubei healthcare alliance,and form province-city-county healthcare alliance.In this way,high quality management,manpower and technology resource sink,overall medical technology level achieves good breakthrough.This promotes the rapid development of healthcare alliance member hospitals in the region.
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Objective: To investigate the hospital employee satisfaction and trustworthiness in the background of the trusteeship mode and to find out the problems after trusteeship.Methods: Minnesota satisfaction questionnaire (MSQ) and the self-made questionnaire were used to conduct the survey.Results: The overall employee satisfaction (3.80±0.86) and trustworthiness (3.95±0.77)were higher.The highest level of trustworthiness concerned the cultural connotation (84.8%) followed by the management concept (82.8%) for overall satisfaction.The lowest level of employee satisfaction concerned income and workload (53.7%), followed by the working conditions and environment (55.3%).The administrative staff satisfaction was higher compared to that of medical staff (p=0.001), which showed significant statistical differences.Conclusions: The hospital has made some achievements after the trusteeship system reform, however, it still needs improvement and further strengthening in many aspects.The hospital must always keep abreast of the demands of workforce and improve the staff satisfaction so as to promote its continuous and sustainable development.
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The paper introduced the background and concepts of municipal trusteeship of district-launched medical institutions, with the trusteeship of women and children′s hospital of Shunyi district as an example.In addition to the main approaches and contributions in improving hospital management, delivery of quality medical resources to primary care, and capacity building, the authors called for the support for standardized healthcare, respect for original hospital culture, and sustained government support to the hospital in question among other points, for reference of further public hospital reform.
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OBJECTIVE:To provide references for the revision of pharmaceutical talents training plan in higher vocational colleges. METHODS:Selecting parts of freshmen,sophomores and junior students majoring in pharmacy in our hospital as subjects, questionnaires were conducted for the effect of hospital“pharmacy trusteeship”policy on their employment selection,and the results were statistically analyzed. RESULTS:Totally 190,390,320 questionnaires were received from junior students,sophomores and freshmen. The surveyed students knew less about“pharmacy trusteeship”policy,only a maximum by junior students of 35.79%(comparison of different grades P0.05). The career direction of hospital pharmacy had the highest proportion of surveyed students in each grade(38.42%-53.13%),especially the freshmen(comparison of different grades P<0.05,comparison of different career direction in a same grade P<0.05). But after knowing the policy,the surveyed students had the lowest recognition for the original career direction,especially the junior students(64.38%)(comparison of different career direction P<0.05). The surveyed freshmen and sophomores were firstly concerned the stability and then the welfare and income of the job,the surveyed junior students were firstly concerned the welfare and income and then authorized strength and the stability of the job. CONCLUSIONS:The pharmacy trusteeship policy has not yet been fully implemented,its effect on employment selection of higher vocational students majoring in pharmacy is relatively backward and the deeper effects have not been appeared completely.
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Objective:To comprehensively improve the quality of clinical nursing, survey the hospitalized pa-tient′s satisfaction and analyze the low satisfaction issues.Methods:Adopt the self-made questionnaire in four pri-mary hospitals.Results:Through the questionnaire analysis, understand the hospitalized patients to improve grass-roots hospital trusteeship overall satisfaction, but satisfaction to nursing technical operation, the life care is low. Logistic stepwise regression analysis, according to the results of nursing technical operation and health education are the main factors influencing the patients′satisfaction.Conclusion:Nursing managers should pay attention to the factors influencing patient satisfaction, and take corresponding corrective measures, improve the patient′s satisfac-tion, to further improve the reform of hospital custody.
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Objective:To explore the feasibility of pharmacy trusteeship in Shanghai medical institutions to provide useful informa-tion for the reform of medicine without added profit and pharmacy transition to clinical pharmacy. Methods: On-site investigation of seven hospitals and one famous drug retail company in Shanghai was performed combined with the communication with relative person-nel and non-random sampling questionnaire survey on the staff of pharmacy. Statwing software was used in the statistical analysis of the data. Results: A total of 93 valid questionnaires in the study were taken back. Although one hospital has achieved great progress in pharmacy trusteeship, most of respondents had negative attitudes and the common thought was that pharmacy trusteeship did more harm than good to the development of clinical pharmacy at present. Conclusion: As a consequence of drug zero interest policy and clinical pharmacy development, pharmacy trusteeship should be explored and attempted. The duties and responsibilities of all parts in pharma-cy trusteeship should be definite in law in order to standardize drug retail market and protect the interests of patient.
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The paper introduced the multi-site physician practice operational in the modes of hospital departmental support,hospital trusteeship,and public-private hospital management,and summarized the merits of such a practice adopted in the background of cooperative hospital operations as follows.A cooperation of common interests enjoys supports of all stakeholders and minimum resistance;better policies and conditions mobilize physicians'incentives; better continuity of medical practice; better public benefits of the hospital.The paper also probed into such issues as setbacks of the practice in such a background,complicity of medical disputes definition and resolution,possible talent drain of public hospitals,and possible impacts on branding and core competence of public hospitals.
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Objective To analyze and evaluate the impact of trusteeship on hospital management and operating status. Methods The state of affairs, technical merit and financial situation and other datawere invested and analyzed in some trust hospital in Xinjiang from 2007 to 2010. Results The number of outpatients, inpatients and surgeries compared before hosting increased by 30. 3%, 61.3% and 26. 3%, respectively. The average in hospital shortened 1.1 days. The growing medical expenditure of average outpatientand inpatient was controlled at a reasonable range. 33 new technologies were carried out after trusteeship. The total revenue in 2010 increased 54.2% compared to 2007, with the balance between revenue and expenditure. Conclusion Hospital trusteeship helped improve hospital operation and management. Measures for hospital trusteeship should be suited to local conditions and sensible.
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OBJECTIVE: To discuss the positive effect of the revolutionary step in drug circulation(Trusteeship of Hospital Drugstore) on the reduction of drug costs and patients' medical expenses as well as on hospital management and development.METHODS: Based on the practice of "Trusteeship of Hospital Drugstore" in our hospital,this article analyzed and expounded the nine "possible" biased view points put forward in research paper entitled "Thoughts on 'Trusteeship of Hospital Drugstore'" published in the magazine "China Pharmacy"(Issue 13 of Vol.18,2007 May).RESULTS & CONCLUSIONS: The innovative practice of "Trusteeship of Hospital Drugstore" carried out currently in Nanjing is an attempt beneficial for drug circulation,which plays a positive and effective role in controlling the drug price over a reasonable range and alleviating patients' burden on medical expenses.
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OBJECTIVE: To discuss whether the "Trusteeship of Hospital Drugstore" of mode is conducive to drug price reduction and reduction of patients' medical expense for the benefit of patients and whether this model is helpful for hospital management. METHODS: It analyzed the possible problems involved in "Trusteeship of Hospital Drugstore": such as it may lead to a "new monopolization of drug management", emergence of new "type medicine representatives", formation of "benefit league", physicians' prescribing "big prescription", thus failing to pose a threat to the "false high" price of drugs in the price chain but bringing about difficulty to hospital drug control and decreasing of drug quality etc. RESULTS & CONCLUSIONS: In view of the fact that current medical level and service income being unable to embody their actual value and the misalignment between supply and demand information of drugs,"Trusteeship of Hospital Drugstore" is still unable to free hospital from the trivial and complicated pharmaceutical affairs, nor can it surely bring down the "false high" drug price and reduce patients' medical expenses for the benefit people.
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Through a thorough analysis of Shandong Provincial Hospital's trusteeship of Shandong Coal General Hospital,the paper delineates the objective conditions and process of the trusteeship,makes a deep study on the trusteeship plan,and expounds the relationship between hospital trusteeship and group construction.It summarizes in an all-round way the theoretical significance and practical value of this case of trusteeship and sets forth the deep-lying problems confronting hospital trusteeship based on group construction.
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Objective To find out about the effect of the trustee policy on the quality of medical workers' material life so as to further improve the trustee reform. Methods An investigation was made via questionnaires on the annual income, consumption structure and housing area of 320 medical workers in hospitals that had adopted trusteeship. Results After the adoption of trusteeship in 2002, the quality of all the medical workers' material life was improved, but there was a signiticant difference among the doctors, nurses and medico-technicians (P