Study on the relative value of surgeons workload in county-level public hospitals based on RBRVS / 中华医院管理杂志

Objective:To form the workload relative value of 10 general surgery projects in Anhui province based on the theoretical framework of resource-based relative value scale(RBRVS).Methods:Cluster sampling was used to identify the 12 county-level public hospitals surveyed from July to August 2019; Expert consultation method was used to select the benchmark project of general surgery and the measured projects; Magnitude estimation was used by doctors surveyed to find the relative evaluation of the surgeries selected, and RBRVS principle was used to find surgeon workload relative value of the 10 surgeries; Pearson correlation analysis was used to analyze the relationship between the charging price of surgeries and the relative value of surgeons′ workload in Anhui province.Results:The study found the time consumption, work intensity relative value and surgeon work load relative value of 10 general surgeries; The relative value of the current surgical item price was positively correlated with the relative value of the doctor′s workload, and the correlation coefficient was r=0.928, P<0.01(bilateral). But in some surgeries, the pricing fails to represent the relative value of the workload. Conclusions:Based on RBRVS theory, 10 localized relative value scales of general surgeons′ workload were developed via empirical studies from such dimensions as time consumption, mental labor, physical labor and risk stress; Pearson′s correlation analysis found part of the pricing in general surgeries as groundless.

Research on evaluation of clinical doctors′ job value in county-level public hospitals in Anhui province / 中华医院管理杂志

Objective:Using the method-point-factor to construct a system of evaluation indexes for clinician positions in county-level public hospitals to assess the relative value of clinician positions in county-level public hospitals in Anhui province.Methods:Questionnaire survey was used for a questionnaire survey of 12 county-level public hospitals in northern Anhui, central Anhui and southern Anhui in the province from July to August 2019. The content of the questionnaire survey mainly includes such doctor′s basic information as gender, age, and department, as well as the doctor′s score on the four dimensions of " post qualification, skills, risks and responsibilities, work intensity and environment" . In this study, Excel 2010 and SPSS 16.0 were used to perform descriptive statistical analysis on the collected data.Results:In this study, a job evaluation system for doctors in county-level public hospitals was established, covering 4 level-1 indicators, 10 level-2 indicators, and 37 level-3 indicators. Among the 1 895 clinical doctors participating in the survey in 12 county-level public hospitals, the average score of doctor′s job evaluation was 768.4 points, of which the neurosurgeons had the highest average score of 800.90 points and endocrinologists had the lowest average score of 735.40 points. There were differences in the overall score rate in the four dimensions of job evaluation, in the order of " risk and responsibility, work intensity and environment, skills, job qualification" (80.09%>79.49%>79.24%>66.72%).Conclusions:The results and grades of clinical doctors′ job evaluation were reasonable. The overall trend of the scores was in line with the job characteristics of doctors, and provided a theoretical basis for improving the internal performance salary distribution system of county-level public hospitals.

Establishing the county-level medical institutions performance evaluation indicator system based on the PATH model / 中华医院管理杂志

ObjectiveTo encourage development of county-level hospitals by building a performance appraisal indicator system for such institutions. Methods Using the PATH model ( a performance appraisal tool for hospital ) quality improvement, an appraisal system was built for such institutions. Centering on patients, this system encompassed such dimensions as public benefits, quality of care and safety, staff and hospital development. Results This system consisted of six level-1 indicators, 21 level-2 indicators and 70 level-3 indicators, each given due weight. Conclusions This indicator system centers on patients, follows guidance of public benefits, and aims at continuous quality improvement, making it an effective in evaluating hospital performance and providing reference for the decision-makers to promote and adjust medical reform policies.

Delicacy management practice of NSFC application process in an affiliated hospital of a medical university / 中华医学科研管理杂志

Objective summarize the delicacy management practices through the NSFC application procedures in a university affiliated hospital,to provide further reference for improvement of the NSFC project approvai ratio.Methods To summarize the management experiences by analyzing the approval number,project category and funds of NCFS from 2006 to 2015.Results The delicacy man agement practices include cultivate scientific research atmosphere by strengthen motivation,initiate application as early as possible,enlarging application number by extensive mobilization,improve applica tion quality by massive training,multi-round updates,tutorial,prevent avoidable errors by cross-over review.Conclusions Delicacy management by scientific research management department during the application process is critical to improve the project approval ratio of NCFS in a hospital.

Analysis of influencing factors for doctors'prescription of essential medicines at county hospitals in Anhui province / 中华医院管理杂志

Objective To analyze the influencing factors for doctors' prescription of essential medicines at county hospitals of Anhui province.Methods Multi-stage random sampling method was designed to conduct an investigation for doctors at nine county hospitals in Anhui province,and SPSS 1 6.0 was used to conduct descriptive statistical,chi-square test and binary logistic regression.Results 50.8% respondents reported that they had prescribed essential medicines with the rate of less than 60%. The factors of doctors'prescription for essential medicines are work experience,average monthly income, policy awareness, recognition, training willingness, training times, hospital support, medication preferences,and drug marketing.Conclusion The prescription rate of essential medicines in the sampled hospitals is low,and the targeted comprehensive intervention measures should be taken to promote prescription rate of essential medicines in county hospitals.

Considerations on the 5-in-1 social co-governance for drug safety / 中华医院管理杂志

In this consideration,the paper described the imperatives of drug safety,constraints of governance by the government,and advantages of social co-governance,proposing the necessity to establish aFive-in-One (referring to the involvement of the government,enterprises,industry associations,media and the public) drug safety social co-governance.In its analysis of the present dilemma o[drug safety governance,the authors proposed such measures as perfecting legal and institutional system,reforming governmental power allocation mechanism,improving the incentive mechanism,innovating governance means and improving social governance ability,for the purpose of enhancing such a co-governance pattern.

Analysis and recommendations on sustainable development of the essential drug system at secondary hospitals / 中华医院管理杂志

This paper made systematic description of the three objectives of sustainable development designed for the policy based on the sustainability theory for the health sector.The essential drug system for secondary hospitals comprises the list coverage and allocation percentage of essential drugs,requirements for bidding and purchasing as well as pricing practice; management and conditions of these hospitals,including leadership determination and competency,doctors prescription behavior,and supportive reforms at these hospitals; external policies and social environment,including government financial subsidy,medical service prices adjustment,medical insurance,and the awareness and attitude of the people on essential drugs.