Résumé
Objective:To evaluate the business performance of an urban public tertiary hospital in Jiangsu province since the comprehensive reform of urban public hospitals started from the end of 2015, for reference in developing relevant policies.Methods:Such level-1 indicators as risk management ability, asset operation ability, revenue and expenditure structure management, asset profitability and future development ability were selected based on literature review, along with 14 level-2 indicators, to build an operation performance appraisal indicator system for urban public hospitals. The entropy weight TOPSIS method was used to evaluate the business performance of an urban public hospital in Jiangsu province from 2015 to 2019.Results:The drugs proportion(a level-2 indicator) under the revenue and expenditure structure management, the growth rate of fixed assets(a level-2 indicator) under the future development ability, and the total return(a level-2 indicator) under the asset profitability, were important ones affecting the business performance of hospitals, with the weights of 0.099, 0.097 and 0.080 respectively. The business operation performance ranking as calculated by the relative closeness, was 2015(0.515), 2016(0.480), 2019(0.467), 2018(0.450) and 2017(0.356) respectively.Conclusions:The reform once resulted in fluctuations in the operation performance of this hospital, with constant declines from 2015 to 2017. With the deepening reform, its performance recovered after 2018 to some extent. It is suggested to improve the business operation performance of urban public hospitals by optimizing their income and expenditure structure, improving their asset operation ability, and matching rationally their asset liability structure, among other measures.
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Objective To learn the business operations of the pilot county-level public hospitals chosen for the 2014 experiment,which were subsidized at different levels in the financial subsidy mechanism reform.Methods County-level public hospitals from 109 counties were sampled as pilots from two provinces of the eastern,central and western regions of China.Descriptive analysis and correlation analysis were made to study their business operations at various subsidy levels.Results Proportional differences in the governmental financial subsidy level make a difference in the revenue and expenditure of county-level public hospitals.The higher the subsidy proportion,the lower the annual average of the total workload of the hospital(P <0.01),the less the inpatient expenditure per hospitalization(P =0.01),and the lower the drug proportion as well(P <0.01 ).Conclusions Financial subsidy plays a key role in the financial balance and business operation of such hospitals.Hence the government is proposed to guarantee its financial subsidy responsibility,to build a long-term financial subsidy mechanism.
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Objective To make recommendations on the development of private hospitals,by means of investigation and analysis of their business operations.Methods Quantitative and descriptive analysis were used to study business operation data from 2011 to 2013 of the 172 private hospitals,in order to learn their present status and development trends.These data were compared with public hospitals in average to identify problems.Results The revenue and expenditure of theses private hospitals increased at a fast pace,with a revenue growth rate of 22.0% and an expenditure growth rate of 15.7% in 2013.Number of visits gradually improved,with an increase of 12.9%.But the rate of bed occupancy was only 68.1%,lower than the average of public hospitals.Conclusions In view of the low resource utilization,the authors recommend such hospitals to improve hospital management systems,and uphold the integrity of business,so as to compete with public hospitals differentially.
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This paper analyzed the economic background,contents and effects of the existing business model of the hospital.On this basis,further study and reform are made on optimal business model of the hospital.The authors recommended that appropriate regional health scale,appropriate technical service,appropriate pricing for charges,appropriate operating cost and appropriate incentive constraints be adopted.These measures will safeguard state assets,public benefit nature of the hospital,enhanced hospital power in general,and compliance in operations,making the people satisfied and healthy.
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Objective To explore measures for the reform of the cooperative business operation system of township public health centers and evaluate in a comprehensive way the results of the reform. Methods A study was made by means of typical investigation of the specific measures taken by 16 township public health centers in Xianju County of Zhejiang Province in the reform of the cooperative business operation system and changes in health resources and service efficiency brought about by the reform were analyzed. Results In the reform, mixed type cooperation was adopted, with public ownership dominating; current assets were assigned in the form of stocks, with all the staff having a share; and a distribution system was established, clarifying the proportions of state, collective and personal interests. As a result, the infrastructures of the centers were enhanced, the service capabilities improved, the financial situation bettered, the value of national assets increased, the potentialities of the staff brought into full play, and social benefits maximized. Conclusion The measures taken by the centers in the reform, which were basically sound and resulted in significant first fruits, could be popularized as an effective model for deepening the reform of health care institutions in the rural areas.