Study On The Current Situation And Countermeasures Of Military Hospital Development Under The Background Of Public Hospital Reform

ObjectivesThe reform of public hospitals is a key content of the national medical system reform.As a component of the national medical service system,military hospitals will inevitably be affected by the reform policies.The central government also clearly requires the implementation of military-civilian integration and the military hospitals participating in public hospital reforms.After the adjustment of the new military organization system,the organization form of military hospitals has also undergone certain changes.In the context of the dual reforms of public hospitals and military organization,how to achieve sustainable and healthy development of military hospitals is an important issue.This research aims to theoretically analyze the external policy environment for the development of military hospitals,study the impact of national public hospital reforms on military hospitals,analyze the operation status of military hospitals,explore the main factors restricting the development of military hospitals,and provide suggestions for the development of military hospitals in the new era.MethodsThe study uses both qualitative and quantitative methods,including literature review,expert interview,field survey,statistical description,TOPSIS methods to carry out research.Firstly,using literature review,policy text analysis and interviews to summarize the progress and achievements of public hospitals reform in Fujian,Shanghai,Anhui,Beijing and other pilot provinces and cities,and theoretically analyze the impact of major medical reform policies on military hospitals.Secondly,using expert interview,field survey and expert consultations to gain insight into the implementation progress,main measures,and problems of military hospitals participating in the public hospital reform.Thirdly,using case study to analyze 4 military hospitals operation data from 2017 to 2019,including operation status and service for the military personnel.Using the TOPSIS method to comprehensively evaluate the operation status.Comparing the operation of two military hospitals with the same type,but located in the east and west respectively,analyzing the relevant indicators of serving the military personnel and the civilian,and finding out the common problems of the hospital development.Finally,based on the results of comprehensive theoretical research and empirical analysis,following the basic principles of national medical reform and military-civilian integration,putting forward suggestions for military hospitals to participate in the reform of national public hospitals.Results(1)In the process of national public hospital reform and military reform,the main problems faced by the construction and development of military hospitals are: imperfect compensation mechanism,difficulties in talent construction,reducing of civilian patients.(2)Through the investigation of 12 hospitals,it is found that the professional and technical personnel in military medical hospitals are mainly in the age range of 35 to 45 years old,and the recruitment of personnel is slow.The problem of brain drain is common in the hospital.There are differences in the focus of future career development among active military personnel,civilian personnel,and hired personnel.The service volume of military hospitals overall declined from 2015 to 2017.The impact of the medical reform policy on the development of military hospitals mainly includes:military hospitals have narrower funding compensation channels,reduced number of local patients,unfavorable medical insurance cost management and control,and large gaps in salary performance between military and local governments.(3)Comparing the medical operation of 4 military hospitals stationed in Shanghai,from five indicators of medical quantity,work efficiency,medical quality,medical income and medical expenses,it is found that the medical business operation of the two hospitals A and B is showing an overall downward trend,while the medical services of the two hospitals C and D are operating well,and the positive indicators are increasing year by year.In all the four military hospital,the service for the military personnel number and the proportion in the total medical services are generally increasing year by year.(4)The military hospitals in the east and west show different operating characteristics due to the different levels of economic development.In areas with a higher level of economic development,the medical service volume is correspondingly higher than that in underdeveloped areas,but the proportion of medicines and medical materials is the opposite.The work efficiency indicators of the two hospitals have both declined,with little difference in the degree of decline,and the resource utilization rate is not high.Corresponding indicators for military service have all increased,and the increase in L hospitals has been significant.Conclusions and suggestionsMilitary hospitals should take the improvement of medical support capabilities as the traction,overcome the difficulties brought by public hospital reform policies,make full use of public hospital reform policy resources,learn from advanced hospital management concepts,and form a benign development mechanism.The main suggestions include: 1.Under the condition that the design of the top-level coordination mechanism is completed,clarifying the development positioning of military hospitals with different levels and types.2.Making full use of local policy resource,solving the main problems that affect the development of military hospitals,and promoting the military hospital construction of disciplines,talents,and technology.3.Military hospitals of different levels and types should implement different policies as needed,strengthen the construction of disciplines and talents,transform development model from scale-oriented to quality-oriented,and utilize the concept of integrated medicine to achieve discipline development.4.Military hospitals should follow the rule of medical services,learn high-quality management concepts,adapt to the performance management concept of local government,optimize internal management,and establish a modern hospital management system.