Analysis Of The Operation Of Public Hospitals In Zhengzhou

Objective:Based on the evaluation of health status and service efficiency of public hospitals in Zhengzhou City,to understand its operation and development trend.Using the results of these analysis to provide a theoretical basis for providing quality and accessible medical services to residents.Methods:Through the Henan Provincial Health Statistics Direct Reporting System,a database was established,which included data on human resources,bed,outpatient and hospitalization,and service quality indicators of Zhengzhou Public Hospital from 2009 to 2017.Statistical methods such as rate and ratio were used to analyze the occupational status and development trends of various health resources in public hospitals over the years.Using the efficiency index model in the normalized analysis method to evaluate the working efficiency of the beds in Zhengzhou Public Hospital.The coordinates were divided into four quadrants: efficient hospitals,transition hospitals,idle hospitals,and press-type hospitals to evaluate their bed utilization types.Structural Variation Degree is used to determine the change direction of the income of each income item of public hospitals during each year.According to literature review and expert consultation,the indicators for evaluating the quality of public hospitals are obtained,then use the TOPSIS method to evaluate the quality of hospital service.By the RSR analysis,the service quality of Zhengzhou public hospital from 2009 to 2012 was carried out in good,general,and poor grades according to the year.Results:1.From 2009 to 2017,the growth of total health expenditure was the most obvious,with the average growth rate(20.76%)and cumulative growth rate(347.06%)being the highest.The absolute number of health workers has increased year by year,but its internal ratio has fluctuated greatly.2.Public hospitals had the highest bed efficiency index(1.1732)in 2017 and the lowest efficiency index in 2009(0.7851).In terms of regions,the efficiency index of Erqi in urban areas was the highest in 2017(1.3712),and that in Huiji was the lowest in 2009(0.3007).Among the counties,Zhongmou had the highest efficiency index(1.4688)in 2011,and Xinzheng had the lowest efficiency index(0.5426)in 2016.In the bed utilization model analysis,the third-level public hospitals are efficiency hospitals for 9 years;the second-level public hospitals are efficient hospitals from 2010 to 2014;the first-level public hospitals are all press-type hospitals for 9 years.3.Before the reform of the pharmacy service,the largest contribution to the degree in the income structure of the outpatient service was the income of medicines,inspections and laboratory tests.The cumulative contribution rate of the three is 85.63%.The largest increase in outpatient income growth is the inspection income(17.79%).After the reform,the most important contribution to structural variation degree is treatment,laboratory test,inspection income,and health materials income.Their cumulative contribution to structural changes was 81.70%,with the largest increase in outpatient income growth being health material income(25.44%).Before the reform,the largest contribution to the degree in the income structure of the hospital was the income of the medicine,the test,and the income from the treatment.The four cumulative contribution rates were 94.17%,of which the largest increase in hospital income growth was the income of inspection(23.25%).After the reform,the largest contribution to structural variation degree was the income of health material,drug,treatment,and inspection.The cumulative contribution rate of these four items was 87.16%,and the largest increase in hospital income growth was the pharmacy service(590.94%).4.After TOPSIS analysis of the quality of medical services in public hospitals for 9 years,the service quality was the best in 2017;the worst in 2010.After the RSR analysis,the equation is obtained according to linear regression analysis: Ci=-0.231+0.142Probit(r=0.953,F=68.544,P<0.001).The service quality of each year is divided according to the theoretical value of Ci.The service quality in 2010 is poor;the service quality in 2011,2009 and 2012-2015 is general;and the service quality in 2016-2017 is good.Conclusion:The resource allocation situation of public hospitals was getting better year by year,but the internal structure is still very uneven and needs further improvement.The utilization efficiency of beds in public hospitals was generally high,but the differences between regions were serious.The efficiency management of beds and the guidance and diversion of patients admitted should be strengthened.The proportion of medicines has declined,but the growth of the medical personnel technical value was not obvious,which indirectly leads to the disorderly growth of other health expenses.The quality of medical services in public hospitals has basically shown a trend of improvement year by year,enabling residents to obtain better quality health services.