Quality assessment of primary healthcare institutions entrusted to private hospitals / 中华医院管理杂志

Objective To evaluate the quality of primary healthcare institutions entrusted to private hospitals as seen by the consumers. Methods The vertical integrated model between Renhe Hospital and Lixian township health center was selected as the case study. Consumer survey data of both November 2016 and September 2017 were collected by using Primary Care Assessment Tool(PCAT) (n=376). Stata 14.0 and Excel 2013 were used for descriptive statistics and multiple linear regression. Results Scoring in such key domains as continuity, comprehensiveness and coordination, and the derivative domains was higher in 2017 than those of 2016. And the differences were significant except for the domain of continuity and coordination (referral). PACT total score in 2017 was 21.28,higher than 19.83 in 2016 and the difference was significant(P<0.01). Conclusions Under the vertical integrated model between Renhe and Lixian, the quality of primary healthcare institutions was improving from 2016 to 2017 from the perspective of consumers. First contact (accessibility), comprehensiveness (services availability) and community orientation of primary healthcare institutions need to be strengthened in the future.

Exploration of the mechanism for performance appraisal and allocation of primary healthcare institutions in Suichang county of Zhej iang province / 中华医院管理杂志

In view of such outcomes of the performance pay practice at primary healthcare institutions as decline of motivation of medical workers,the county explored the mechanism of graded performance appraisal and allocation,against the macro background of ceiling setting for the total of performance pay andbalance subsidy and total amount controlfiscal policy.The following measures are taken,namely a dual linkage to relate the performance appraisal outcome of a township hospital with both allocation of fiscal subsidy and setting of the merit-based performance pay standard per person;higher ratio of merit-based performance pay;floating of the performance pay level per person for the institution in question;separation of the performance pay of the chief leader from others;and subsidies for remote mountainous areas.It is proposed by the author to build a routine increase mechanism for both the total of performance pay and fiscal subsidies,to combine specific subsidy with pay for services,and to join funding compensation with service performance.These measures are expected to create a new mechanism for performance pay allocation,featuring more pay for more work and more pay for better performance.

A study on revitalization of primary healthcare organizations through development of standard functions

Primary care lays the foundation of national healthcare systems, but it has been weak in playing its role correctly because of legal and environmental attributes surrounding the healthcare industry in Korea. This study is conducted to concretize the definition and scope of primary care and to deduce its standard functions to contribute to establishing the healthcare delivery system and appropriate healthcare systems embracing socio-environmental leverage. The term primary healthcare institution was adopted based on literature review to achieve the research goal. The principle diseases appropriate for the primary healthcare institution based on ambulatory care sensitive conditions were analyzed, and the standard functions were deduced by matching these diseases with current procedural terminologies using CrossCoder package. Based on the analysis, the primary healthcare institution-specific diseases were 53 specific diseases under 23 broad disease groups. The standard functions were deduced in three categories of the standard functions of the entire primary healthcare institutions with 100% frequency, common standard functions with 70% frequency, and peculiar standard functions specific to diseases or body systems. These functions included outpatient evaluation and measurement, various factor tests through blood collection, and X-ray. Establishing the standard functions for the primary healthcare institution can promote patient reliability on primary care, alleviate health demand congestion toward large-sized advanced healthcare institutions. Furthermore, it contributes to establishing and reinforcing other healthcare policies related to the healthcare reimbursement system and referral system, and fosters primary care physician education. Most importantly, it reduces the national health expenditures by realizing efficient and effective healthcare delivery.

An Analysis of Cases Referred from the Primary Healthcare Institution with Suspected Developmental Dysplasia of the Hip: A Prospective Study / 대한정형외과학회잡지

PURPOSE: A prospective, epidemiological investigation was performed in the patients referred to our hospital with suspected developmental dysplasia of the hip (DDH). MATERIALS AND METHODS: Of the 121 patients referred from the primary healthcare institutions, with suspected DDH from January 2006 to December 2007, 82 patients who were able to be followed up for at least 2 years were enrolled in this study. Confirmation of the diagnosis was determined by patient history, physical examination, simple radiographs, and ultrasonography. Epidemiological investigation was performed in the total 82 cases which were referred from the primary healthcare institution and were confirmed as having DDH, and at least a 2-year follow up was performed in all these cases. RESULTS: Of the 82 cases, 56 cases (68.3%) were within normal limits (W.N.L.), 15 cases (18.29%) were confirmed as having DDH, and 11 cases (13%) were diagnosed with several different diseases other than DDH. Compared to the total 82 cases, the percentage of females, presence of family history was statistically higher in the cases confirmed as having DDH. However, the incidence of breech presentation was not statistically different between all cases. 61 cases were referred by pediatricians and 21 cases were referred by orthopedic surgeons to the primary healthcare institution, and the diagnostic rate of DDH was statistically higher in the cases referred by orthopedic surgeons (p>0.05). CONCLUSION: The rate of confirmation of the suspected diagnosis of DDH would hopefully increase through the establishment of physical examination protocols or radiologic study and systematic training programs that could be applied in the primary healthcare institution.