Analysis on the Revenue and Expenditure Structure of County Public Hospitals in Shanxi from 2010 to 2016 / 中国卫生经济

Objective:To analyze the revenue and expenditure structure of county public hospitals in Shanxi since new medical reform in order to provide evidence about county public hospital reform.Methods:Related data of revenue and expenditure in county public hospitals of Shanxi from 2010 to 2016 were used and analyzed by descriptive analysis and the indicators of the structural changes.Results:The effect of compensation mechanism reform appeared;drug income ratio descended.Drug income was still the important factor to keep hospitals running normally;fiscal subsidy increased by years,public welfare of county public hospitals was prominent;technical services revenue which realized the value of technical work performed by medical personnel changed little.Conclusion:The cost structure of public county hospitals needed further adjustment.It should establish the comprehensive evaluation system of unreasonable growth of medical expenses,actively implement modern hospital management system,carry out synthetic?configuration of medical resources in county area,establish a dynamic medical service pricing mechanism combining market regulation with government guidance under the government's macro-controlling,and introduce the disease related group to hospital performance evaluation.

Analysis on the Economic Operation of Township Public Hospitals in Jiangxi before and after the Medical Reform / 中国卫生经济

Taking 175 township public hospitals in Jiangxi as the samples,descriptive statistics and comparative analysis were applied based on their financial yearly report data from 2012 to 2016 to analyze the operation situation of hospitals before and after the public reform,analyze the influences of medical reform policies on township public hospitals and propose relevant policies,so as to promote the soon coming urban public hospital reform in Jiangxi.

Bootstrapping Data Envelopment Analysis of Efficiency and Productivity of County Public Hospitals in Eastern, Central, and Western China after the Public Hospital Reform / 华中科技大学学报（医学）（英德文版）

China implemented the public hospital reform in 2012.This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern,Central,and Western China after the 2012 public hospital reform.Data from 127 county public hospitals (39,45,and 43 in Eastern,Central,and Western China,respectively) were collected during 2012-2015.Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist.The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test.The average bias-corrected TE values for the four-year period were 0.6442,0.5785,0.6099,and 0.6094 in Eastern,Central,and Western China,and the entire country respectively,with average non-technical efficiency,low pure technical efficiency (PTE),and high scale efficiency found.Productivity increased by 8.12％,0.25％,12.11％,and 11.58％ in China and its three regions during 2012-2015,and such increase in productivity resulted from progressive technological changes by 16.42％,6.32％,21.08％,and 21.42％,respectively.The TE and PTE of the county hospitals significantly differed among the three regions of China.Eastern and Western China showed significantly higher TE and PTE than Central China.More than 60％ of county public hospitals in China and its three areas operated at decreasing return scales.There was a considerable space for TE improvement in county hospitals in China and its three regions.During 2012-2015,the hospitals experienced progressive productivity;however,the PTE changed adversely.Moreover,Central China continuously achieved a significantly lower efficiency score than Eastern and Westem China.Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China,especially in Central China.

Relationship between remuneration incentive and satisfaction of medical staff in county public hospital:Based on questionnaire survey in Heilongjiang Province / 中国卫生政策研究

Objective: To understand the effects of remuneration incentive and their influences on job satis-faction in county public hospital. Methods: Stratified random sampling was adopted. Six county public hospitals in county level in Heilongjiang province were selected as the sample. Exploratory factor analysis was used to ana-lyze the remuneration incentives, descriptive statistical analysis and logistic regression analysis were used to ana-lyze the effects and their influences on work satisfaction. Results: remuneration incentives are divided into four dimensions that comprised a total of 16 items, which including direct material rewards, indirect material re-wards, occupational rewards and social rewards. The surgeon’s job satisfaction is higher than the physician, and is lower than the obstetrics and gynecology and pediatrics. Technician and nurses’ satisfaction is lower than the general practitioner. The medical staff who worked less than5 years has the lowest satisfaction. Authorized staff’s satisfaction is lower than off-staff. Direct material rewards and occupational rewards are related to job satisfac-tion. Conclusions:Material rewards were in low level, and non-economic incentive was insufficient. The salary incentive for highly educated talents should be strengthened.