| ObjectiveThe study on public hospital performance is to discuss management of hospital performance by analyzing factors that influence hospital performance, and the responsiveness from the perspectives of patients in clinic visit and hospitalized and health staff. The study also analysis what factors affect those medical staffs' satisfaction with their work and income. Finally, a policy suggestion on further improving hospital management efficiency is put forward to enhance professionals working enthusiasm and the total achievements of a hospital so as to increase the corefore for hospital competition. Research Method1. The study uses field investigation and panel discussion to evaluate hospital performance. A specific survey on four tertiary hospitals affiliated themselves to three medical universities and Shanghai municipality was conducted. Data were collected in each hospital from 1999 to 2002 about service quality and effectiveness, financial condition and study/creative ability. Through analysis on ten comprehensive hospitals, twenty district center hospitals and fourteen community hospitals of Shanghai municipality, a "Star System" was brought forward in hospital performance evaluation.2. A pilot study on the responsiveness of outpatients and inpatients in tertiary hospitals, special tertiary hospitals, secondary hospitals, community hospitals and rural township health centers was held. Questionnaires include basic information for informants and perspective of responsiveness' aspects. Usingeight elements of responsiveness provided by WHO, we designed respective questionnaire for inpatient, outpatient and health workers based on the study results.3. A specific survey was conducted in four tertiary hospitals affiliated themselves to three medical universities and Shanghai municipality, four secondary hospitals and four community hospitals in district or county in Shanghai. 872 outpatients, 637 inpatients and 1134 health workers were randomly selected to face-to-face inquiry. Likert scale (always, often, sometime, never) is used, and evaluated on total lever of eight elements (very good, good, moderate, bad, very bad) in analysis.4. By means of quantitative and qualitative studies, surveys and interviews were conducted for the medical staffs, patients and community residents. Eight hundred and nine medical staffs, 365 patients and 300 community residents participated in the survey. Keeping the fundamental information of subjectss in mind, the questionnaires were given to the medical staffs in four aspects: hospital culture and features, values, working conditions and economic incentive situation and incentive method. As for the medical service clients and community residents, three aspects were considered. They are reasons of choosing the hospital, familiarity with medical staffs and views on the incentive mechanism.Research Results 1. The results from service quality and effectiveness, financial condition and study/creative ability showed that sample hospitals have higher efficiency, however they should pay more attention on the financial operation. Through two rounds of expert consultation, the author selected 31 indicators to evaluate hospital performance based on weighted. The results showed that evaluationmethod had the characteristics of stability, reliability and availability. 2. The pilot study showed that most patients could get prompt attention. They thought that they had treatment autonomy, the proportion of free choice on doctors or nurses was increased. Most of patients would talk their confidential medical history to doctors freely, and they could get rational explanation from doctors. The health reform in Shanghai has paid attention on patient's responsiveness, and got better efficiency.3.The results of responsiveness study showed that most important parts of responsiveness were dignity, autonomy and confidential. Sex, age, education and professional title were potential factors effect on perspective of responsiveness.
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