Résumé
Objective To assess the implementation of Healthcare Improvement Initiative ( the Initiative)by 136 tertiary hospitals nationwide in 2017, and provide reference for improving relevant policies. Methods Hospital questionnaires 1 and 2 were designed, and data were collected by self-report and expert scoring.Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H(K), and Spearman rank correlation were used for statistical analysis.Results The median score of the first 11 dimensions of these hospitals was 91.89% , and that of the first 12 dimensions of 30 women and children hospitals was 90.54%.The total score rate of the top 11 hospitals in the eastern region was higher than that of both the central region and western region(P<0.001).The total score rate of the first 12 dimensions of women and children′s hospitals in the eastern region was higher than that in the central and western regions(P=0.032).The total score rate of the first 11 dimensions of the national level hospitals was higher than that of the local hospitals ( P =0.004).The correlation coefficient between the total number of patients and the total score of the first 11 dimensions and the first 12 dimensions was 0.578 and 0.413, respectively.Conclusions Implementation of the Initiative is satisfactory in general. There are however still rooms of improvement for hospitals in the central and western regions, and local level hospitals as well. General hospitals are better than TCm and specialist hospitals.The larger the scale, the better the performance in service improvement.
Résumé
Objective To assess the effectiveness of China Healthcare Improvement Initiative from 2015 to 2017.Methods The 3rd round evaluation was conducted from December 2017 to January 2018 at 136 tertiary public hospitals, and the results were compared with the previous two surveys. Hospital Questionnaire, Patient Questionnaire and Doctor-Nurse Questionnaire were designed and administered by experts, onsite investigators and self-administered cellphones respectively. Data were analyzed by SPSS software.Results In 2017, the hospital performance scoring of these hospitals was 91.77% , which rose steadily from 2015 and 2016.Significant dimensions scoring the highest included the appointment system, rational allocation of medical resources and IT use.Overall patient satisfaction remained over 90% with both outpatients and inpatients. Defects however remained in such areas as long waiting time, insufficient communication between doctors and patients.Heavy workload was common among medical staff, in addition to poor staff welfare and poor health, resulting in declining job satisfaction.Conclusions The Initiative has made significant progress in the past 3 years, while there still remain some important challenges.Substantial improvement of the welfare and job satisfaction of medical profession deserves a top priority in healthcare reform in the future.