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Objective To analyze the problems and mechanism obstacles existing in the allocation of health human resources in medical institutions in poverty-stricken counties of Hubei province, and propose targeted policy recommendations. Methods The stratified random sampling method was used in an on-site investigation conducted at 5 county-level hospitals and 9 township hospitals in 3 poverty-stricken counties of Hubei province. Results The allocation of human resources in such counties showed an overall trend of improvement year by year. However, some of the counties still faced such problems as inadequate health workforce, unreasonable structure of health manpower, and great gaps of health manpower structure within the county. In most of the hospitals, the proportion of health technicians with bachelor's degree or above fell below 50% . In county hospitals, the proportion of personnel expenditure was generally less than 15% from 2013 to 2016. Conclusions The allocation of health human resources in poverty-stricken areas is facing such mechanism obstacles as limited financial input, restrictions of staffing quota, and lack of cooperative motivation by medical institutions. It is necessary to clarify the responsibility of the government and guarantee the fiscal support of personnel expenditure. It is also imperative to promote the reform of the personnel practice in the health system, strengthen the construction of the health talents guarantee mechanism at the primary level, optimize the vertical cooperation mechanism of medical institutions and promote the integrated health management of counties-township-villages.
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The index weight has very significant role in the performance evaluation system for the public hospitals’ financial governance. This paper employed the analytic hierarchy process associated with the Delphi method to determine the index weight based on the previous studies. The index of maximum weight is non-profit (0. 35), fol-lowed closely by financial responsibility(0. 18), asset performance(0. 18), financial performance and risk (0. 18), and the index of minimum weight is society satisfaction ( 0 . 06 ) . The index weight guidance and the practical index system application were also interpreted in order to really play the significant role during the performance evaluation for the public hospitals’ financial governance.
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This paper construct an evaluation index system for performance appraisal of public hospitals financial governance,using the meta-analysis,expert panel discussion and Delphi method.With two rounds of expert consultation and panel discussion,such an evaluation index system was completed,comprising 6 primary dimensions,15 secondary dimensions and 48 evaluation indexes.
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This article discussed basic theoretical issues involved in evaluating the financial governance performance of China's public hospitals.Discussions in it cover such aspects as choice of perspective for evaluating their financial governance performance,scope of financial governance performance evaluation,subjects of finance governance of public hospitals and their responsibilities and objectives,as well as construction of basic dimensions of their financial governance performance evaluation.
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This article introduced the public governance theory into the study of financial governance of public hospitals and analyzed the internal logical relations between public governance theory and financial governance study under the framework of public hospital management.These include the present background of financial governance of public hospital and its demand for public governance,public governance theory's applicability and its inspiration in the field of financial governance of public hospitals.The inspirations of public governance theory are as follows:repositioning of government governance responsibility and diversification of governance subjects,synergy of governance structure and shared competency of governance power,as well as the accountability of governance behavior and performance evaluation of governance.
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Objective To understand the current economical operation of public hospitals in Hubei province and its effect on their public welfare performance. Methods To collect data in field survey and to analyze the current economic situation of such hospitals in the province based on relevant statistics.Results Financial revenue and expenditure of these hospitals keep rising and achieving a balance in general; for the insufficient government financial subsidy, 90% of the revenue of such hospitals come from their medical services and drugs sold; the per capita revenue of these public hospitals maintains a yearly rising trend; their asset-liability ratio was relatively high. Conclusions The public welfare performance of these hospitals tends to be impeded by the reform on the macro economic system and health policy changes, on top of the attraction of economic interests. Improving the government subsidy mechanism for public hospitals and standardizing the financial management mechanism of public hospitals.
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The paper presented the theoretic basis for the comprehensive hospital evaluation system, and initiated the indicator system for hospital comprehensive evaluation results with both Delphi method and the balance scorecard. Two rounds of experts consultation have decided to evaluate hospital comprehensive strengths from such aspects as hospital resources deployment, business process, financial standing, customers, customers, public welfare and development potential of the hospital. Under these grade-1 indicators are 13 grade-2 ones and 83 grade-3 ones. The importance, operability and sensitivity of these indicators are accepted by experts unanimously.