| IntroductionIt is known that the reforms in rural township hospitals are the key of rural health services reform and development in China. Since the planned economy system was over, the circumstance of the township hospitals has been changed greatly, which brought many difficulties to them. Thus, the reforms in the township hospitals were imperative. In multiform reforms of the property right, cooperative management reform performed well and was regarded as a promising way to develop the township hospitals in new century. Lack of general evaluation, the reform could not be deepened in theory and be popularized in practice farther. In 1998, sixteen township hospitals put cooperative management system into practice in Xianju county, Zhejiang province. Thus, many valuable original data and cases were accumulated, which became the sample of the study.ObjectivesThe aim of the study was to summarize the methods of cooperative management system and evaluate its achievement in township hospitals. Finally, some valuable suggestions were summarized to implement cooperative management system normally.MethodsAll sixteen township hospitals, which put cooperative management system into practice in Xianju county, were investigated. The trained hospital managers completed the Township Hospital Reform Questionnaires includingsocioeconomic condition of the town, procedures of cooperative management system, medical resources, health services and so oa Using the come-across investigation, the medical employees completed the Opinion Questionnaires and the patients completed the Satisfaction Questionnaires in the hospitals. The procedures of cooperative management system were summarized in aspects of capital treatment, cooperative pattern, stock allot, benefit distribution and personnel management. By longitudinal and transverse contrast in basic construction, employee's enthusiasm, health services ability, economic running and social benefit, the achievement of the reform was evaluated. Based on the experiences and lessons in the past practice, some valuable suggestions were summarized to implement cooperative management system normally. In the data analysis, T-test, variance analysis and chi-square test were used in SPSS 8.0 for Windows.Results16 township hospitals with cooperative management system were completed investigation. 122 medical employees and 74 patients completed the Questionnaires. 98.7% of total items were fulled in.The main measures of cooperative management reform in the township hospitals included: ゛uditing the property and quitting current assets that was 1493600 Yuan; ﹕etting up national stock, collective stock and employee's stock in the stock right system; ﹑aying from 4000 to 6000 Yuan for shares each employee; ヾefining the components of income and expenditure; ?distributing the wages of the employees according to theirs shares, longevity and services; ﹎aintaining the character, functions and status of the township hospitals.Great achievements have been gained in the township hospitals since the reform. The amount of the medical employees, the health buildings and the funds for medical equipments increased significantly in basic construction. The ability of health services improved greatly. The clinical load and medical examination items added, while the public health tasks were completed excellently. Economy condition became better. The amount of the operation profit, permanent assets and the employee's income increased significantly. National, collective and employee's fund aggrandized harmoniously. Thus,national and collective capital incremented. The employee's workload increaded and the attitude to medical services became better. The interesting of taking part in occupational education and management also enhanced significantly. Social benefit was good. The health services improved and outpatient expenditure did not increase, which was much less than the average expenditure in Zhejiang province. Most of the patients gave voice with satisfaction hi the inv...
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