Research On The Construction And Applied Reasearch Of Public Welfare Evaluation Index System Of Community Hospital

Background and Objective: As the main provider of medical and health services in China,the realization of public welfare is closely related to the interests of Chinese people.So with the development of social economy,the lack of public welfare in public hospitals has become an important livelihood issue in our society.In the context of the New Medical Reform,the government further clarified the public welfare nature of public health.Strengthening and improving the public welfare construction of public hospitals is of great significance to promote hospitals at all levels to implement basic medical services and public health services,and to meet the growing demand of all people for medical and health services.At present,the public welfare evaluation of public hospitals in China mainly focuses on hospitals at the county level and above,so it is urgent to establish a set of evaluation indicators suitable for the public welfare of primary hospitals,so as to provide reference for improving the public welfare of hospitals.How to evaluate the public welfare degree of public hospitals at all levels through scientific methods,so that public hospitals can return to public welfare as soon as possible and provide residents with high-quality,cheap,convenient and accessible basic medical services and public health services is an urgent problem to be solved.Taking community hospitals as research targets,the purpose of this study is to summarize the basic connotation and extension of different levels of public hospitals’ commonweal,construct an evaluation index system with high validity and reliability for grass-roots public hospitals by understanding the main factors affecting the public welfare of community hospitals at present in China.Representative community hospitals would be selected for empirical research to test the practical significance of the construction of evaluation index system.In the end,the study aims to put forward the specific countermeasures for community hospitals to return to public welfare in the comprehensive reform of public hospitals,so as to provide scientific basis for the government’s decision-making,evaluation and supervision.Thus,it will guide the construction of basic medical and health system in China,and guarantee the realization of public welfare of public hospitals in multiple dimensions.Method: Through literature research,this study integrates the latest research progress and related theoretical basis,and it summarizes the connotation and extension of public welfare of public hospital at different levels.Combined with the current development of community hospitals in China,this paper analyzes the influencing factors of public welfare.The grim trend and the fact of consciousness fades of the public welfare of community hospitals are clarified.The basic framework and primary alternate indicators of the public interest evaluation system are determined.On the basis of Delphi consultation method,through two rounds of expert consultation,the public welfare evaluation index system of community hospitals are constructed and its first and second level index weight coefficient are determined by combining with AHP.TOPSIS analysis method is adopted to score and rank the relevant index operation data of some community hospitals in Jiangsu Province,and comprehensive evaluation is carried out.Results:1.The connotation of public welfare of community hospitals is reflected in the non-profitability,fairness,accessibility,quality and efficiency of medical and health services.In the context of medical and health system reform,the main factors that affect the public welfare of community hospitals include medical service effect,service cost,basic public health service,hospital operation status and social benefit output.2.The evaluation indicator system for community hospitals was set up,which contained 7first grade indexes covering medical service quantity,quality of medical service,the operation of hospitals,patients’ economic burden,basic public health services,policy tasks and social responsibilities,teaching and training,and 25 second-class indicators including the annual outpatient and emergency volume,annual discharge,number of years of referral patients,recovery rate and so on.3.Through TOPSIS evaluation research,the public welfare evaluation indexes of the six selected sample community hospitals were obtained,from high to low: hospital C(public welfare index: 0.7153),hospital E(public welfare index: 0.6760),hospital A(public welfare index:0.5899),hospital F(public welfare index: 0.4533),hospital B(public welfare index: 0.3351),hospital D(public welfare index: 0.2062).Conclusion: The evaluation indicator system is relatively complete and scientific with a certain representativeness and operability,which can be used for the public welfare evaluation of community hospitals and other basic hospitals.The main factors that hinder the realization of public welfare of community hospitals include imperfect financial compensation mechanism,imperfect two-way referral system,insufficient capacity of basic public health services and laggard service mode.In terms of strengthening the construction of public welfare in community public hospitals,the government should play a leading role in establishing and improving the financial compensation mechanism,promoting the implementation of the two-way referral system and improving the level of medical security.While community hospitals should improve the capacity of basic public health services and current service mode,and strengthen the construction of talents.What’s more,a public welfare-oriented evaluation system of community hospitals needs to be established.Only in this way can the goal of public welfare be realized.