Research On Establistment And Application Of Evaluation Index System Of County-level Public Hospital Comprehensive Reform

The county-level public hospitals,which serve as the link between the urban and rural medical and health service systems,has played an improtant role in linking the urban medical institutions with the rural three-tiered medical service networks.The comprehensive reform of county-level public hospitals is the key link indeepening the health system reform and alleviating the issue of “costly in seeing a doctor and difficult in seeking medical care” effectively.In order to promote the comprehensive reform of county-level public hospitals,the government has launched some policies in 2012 and 2015 respectively,which were also requested to evaluate the effectiveness of the reforms.However,there is no corresponding evaluation index system in the existing research.Therefore,this paper decided to build an evaluation indexes system on the basis of comprehensively understanding and grasping the direction and goal of comprehensive reform of county-level public hospitals,by considering the systematism,integrity,and synergy of the reform.The evaluation indexes system contains three dimensions,which are the development indexes,the public welfare indexes and the economic indexes.Then,the study used the evaluation indexes system above to evaluate the effectiveness of comprehensive reform of county-level public hospitals by taking Zhenjiang city as anexample.Finally,the study came up with some countermeasures which aim at solving the problems during the comprehensive reform of county-level public hospitals.This paper elaborates some concepts and theories related to the comprehensive reform of county-level public hospitals.Then,according to the assessment model constructed,built the evaluation indexes system by following the principles of systematism,operability and comparability.Thirdly,using expert consultation method to select indexes and calculating the weight of indexes by AHP.The evaluation indexes system contains 3 first-level indicators,14 second-level indicators and 54 third-level indicators.Finally,using the evaluation system,the paper evaluates the effectiveness of the comprehensive reform of Danyang City People’s Hospital,Yangzhong City People’s Hospital,and Jurong City People’s Hospital from 2013 to 2017.Judging from the evaluation results,it’s not hard to find that the comprehensive reform results and problems coexist in county-level public hospitals.Through the reform,the capacity of sustainable development of county-level public hospitals has increased.Public welfare has enhanced,and the mechanisms for remedying medicine have been reversed.However,there are still some problems in the comprehensive reform.There is lacking of outstanding talents in county-level public hospitals,compensation mechanism is no perfect,the progress of grading diagnosis and treatment systems advances slowly,the medical service price adjustment is not in place,the balance ratiobetween income and expenditure falls,and hospitals face loss crisis.Based on the assessment results,and in orderto deepen the comprehensive reform,the following countermeasures are proposed.Firstly,strengthening the capacity of sustainable development inhospitals,the main point is improving talent recruitment and introduction policy,resolving the historical debt of county-level public hospitals.Secondly,ensuring the public welfare of the hospital through to implement the responsibility of local governments’ financial input and adjust the prices of medical service dynamicly.Thirdly,promoting the implemtentation of a hierarchical diagnosis and treatment system through to promote the reform of the composite medcial insurance payment,establish a reasonable interest distribution mechanism and improve the service capabilities of primary medical institutions.Finally,strengthening the internal management through to improve the performance appraisal system and enhance the hospital fine management.