| BackgroundSince the Reform and Opening of China, the demands of the masses of the people are getting higher and higher. Not only the improvement of material life level, more is focus on health and quality of life, which to its closely related to medical and health proposed higher requirements. Those put forward a higher level of requirements for medical and health work. But it still exists some outstanding contradictions and problems between the development status of Shandong medical and health and the people’s growing health needs. For example, farmers’difficulties in getting medical care, which is too expensive for them to afford and might cause them return to poverty because of illness. "The evaluation and suggestion on the reform of Chinese medical and health system" has pointed out that the reform of China’s medical and health system is not successful in general. This basic conclusion has also become a prelude of China’s new round policy of medical and health system reform. With the deepening of the reform of medical and health system, as the main body, county-level public hospitals are also getting more and more attention. County level hospitals are an important part of medical and health service system and the major medical institutions of health service-seeking. But many problems are gradually exposed, and become more intense and serious. As a result of lack of government financial investment, low price of medical service, compensation system for the medical cost through drug-selling profits, blind construction and many other reasons, a series of problems have emerged, such as declining county public hospital insolvent, excessive medical treatment, virtual high drug prices, overweight burden of medicine, declining satisfaction.ObjectivesIn order to understand the effect of public hospital Reform of Public Pilot Hospitals in Shandong Province, this study analyzes the effect and existing problems of the comprehensive reform of 71 county-level public hospitals in Shandong province and puts forward some feasible suggestions to provide more scientific and useful references for comprehensive reform of county-level public hospital in Shandong Province.MethodsThe study uses the data derived from the health financial annual report data of the first batch of the pilot hospitals from 2012 to 2014, including 71 county-level public hospitals. The specific research methods include literature review, group discussion, quantitative analysis, comparative analysis and qualitative analysis, and so on.ResultsThe operation of 71 pilot hospitals is generally good, but there are also big problems needed to be urgently solved from 2012 to 2014:the pilot hospitals have poor hospital solvency and the problems of serious borrowing and over-Indebtedness; The government financial aid investment is still insufficient, and the distribution of medical and health resources is not balanced; patients with drug burden is reduced somewhat, but the phenomenon of overweight burden of medicine is not yet fully get rid of; hospital income and expenditure structure still needs to be optimized, and the medical service price adjustment is not in place; the system and mechanism is not reasonable, of course, the level of medical service needs to be further improved.ConclusionsPromote coordinated comprehensive reform of county-level public hospitals, and make a good "combination of boxing"; we should be rational allocation and optimization of health resources, and increase the financial subsidies to the county public hospitals; reasonably control the size of county-level public hospitals and strengthen the financial risk control management; to strengthen the internal operation mechanism reform of county-level public hospitals and to improve the service efficiency the efficiency of the hospitals’services; reasonably adjust the prices of medical service and to further reduce drug prices; promote the level of information construction and enhance the service ability of county-level public hospitals. |
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