Research On Performance Evaluation Of Medical Services In County Public Hospitals Based On Patient Experience

Objective:The goal of public hospital reform in our country is to promote public hospitals to e fulfill the public service functions and provide safe,effective,convenient and inexpensive medical health services for the masses through the reform of public hospital management system and operation mechanism.Therefore,whether the people are satisfied with the experience of medical services or not is an important index to measure the effectiveness of public hospital reform and the performance of hospital medical services.This study evaluated medical service performance of public hospitals from the perspective of the patient experience,summed up the reform results of county public hospitals.In addition,the paper found the problems of hospital medical services,analyzed the main factors that affected the medical service performance,in order to provide policy recommendations for the government to carry out hospital service supervision,play a positive role of improving the effectiveness of medical services and satisfaction,then promote the implementation of county-level public hospital reform.Methods:This paper studied the common methods of hospital service performance evaluation at home and abroad and sumnarized the theory,method,effect and influencing factors of hospital service performance evaluation based on patient experience by the literature research method.Combined with the policies of local county-level public hospital reform,the article sum up the relevant policies which had a great impact on patient’s medical service experience.We evaluated medical service performance of sixteen county-level public hospitals from four provinces through site investigation.The results of medical service performance evaluation of county-level public hospitals were calculated according to the scale scoring method.We compared the effects of different patient characteristics on the performance of medical services by using single factor analysis of variance,multiple linear regression and correlation analysis.At the same time,combined with the policies of different provinces and the county level hospital reform,the study compared the results of patient experience in different hospitals and different policies in order to discover the current problems of county public hospitals and the focus of future reform.Results:The patient experience scale can be used to evaluate the effectiveness of public hospital reform.There were significant differences in the performance evaluation of medical services in 16 county-level public hospitals,which could be different because of the different and specific measures of the various regions.Different patient characteristics had different effects on the performance evaluation of medical services.Univariate analysis showed that the patient experience had statistical differences in terms of patient type,age,sex,marital status,educational level,occupation,type of medical insurance,disease diagnosis,disease type and disease severity.Multiple regression analysis found that patient type,disease diagnosis and educational level were factors influencing the patient experience.The results showed that the overall evaluation of medical services was better,the scores of secondary indicators were more than 5 points and the first indicator"overall evaluation" was 7.536 points;The secondary indicators "demand response","respect for patients","communication between doctors and patients"and "privacy protection" in the first indicator "doctor-patient relationship" had higher scores,but "disease awareness" score was low,which indicated that relationship between doctors and patients was good and patients had low level of knowledge with their own disease.The burden of medical expenses was still heavy,especially in the inspection fees and drug costs;The correlation between the technical level and the overall evaluation of the patient experience was the highest,but the county level of public hospital technology level was very low,especially the technical level of medical personnel;"Service efficiency" score was low which showed that patients waited for a long time in the treatment process.By comparing the 16 hospital performance scores,eombined with the implementation of local policies,the paper found that establishing hierarchical medical system and optimizing the service process would improve the efficiency of medical services,strengthening the management and supervision of the circulation and use of drugs would be conducive to reducing the cost of drugs.Compensation mechanism reform was conducive to control the unreasonable growth in medical expenses.Strengthen the service supervision and reform of pay system were beneficial to standardize the medical service behavior.Policy suggestions:In order to solve the problems of medical services that exist in county level public hospitals,the following suggestions were put forward:Comprehensive policies of medical,medicine and medical insurance should be taken to further break’drug-maintaining-medicine’.Optimize the diagnosis and treatment service process by information technology.Promote the implementation of hierarchical diagnosis and treatment with medical union as the carrier.Strengthen the construction of qualified personnel at the county level hospitals to improve the medical technology.Multi-directional supervision should be taken to control medical expenses unreasonable growth.