Study On Feasibility Of The Divided Of Income And Expenditures Within Capital Management Model In Township Health Centers

Objective:Estimating the government's current financial burden, incomes and expenditures status of township hospitals and the financial management modle, to calculate the financial burden after the township hospitals implemented the divided funds management of incomes and expenditures. On this basis, initially judge the feasibility of the divided funds management model, explore the methods to establish the model, in order to provide the relevant policy recommendation.Methods:1. Document Analysis: Analysis of the literature refers to gather information, identify, organize literature through the study of literature, a scientific understanding of the facts to the method. In this paper, through the collection at home and abroad related to hospital management theory, practice and research progress in divided income and expenditure related policies and regulations. And on this basis, summed up some of that we can draw on the theory and methods, this study identified the target, content, methods, indicators and survey questionnaires and interviews outline.2. Description of the statistical analysis: descriptive statistical analysis method is calculated by statistical charts and data distribution of samples to understand the characteristics of the distribution of observations. In this paper, use this method of township hospitals balance of payments, financial management, operation carried out summary and analysis of information.3. Factor Analysis: factor analysis is to find such a correlation between dominance of the finite number of observations to be the potential variables from a number of variables between the original start, and use it to explain the original multi-variable analysis. In this paper, use this method to analysis the balance of payments in township hospitals, financial management and operation of the relevant factors analysis.4. Sociology qualitative research methods: the Sociology of qualitative research methods is access the survey information and to further explore deep-seated problems through some factor which were can not be quantified targets or unable to directly,. This paper used to the field of health management and leadership depth interviews with experts on the implementation of divided income and expenditure performance, and countermeasures, and other factors related issues.5. Macroeconomic policy analysis: This methods is analysis the development of policies and regulations, government guidance and policy environment.This paper is making a judgement to feasibility of divided income and expenditures within capital managemet modle in township health centers based on China's health policy legal, financial management, health policy guidance and the Government of value judgement.6. Typical case analysis is the basis of objective selection of representative examples of regional or related to a systematic analysis of the way. In this paper, there is select two lines of the pilot areas for analysis.The results:1. The results of estimates the total of expenditure on general and central hospitals :The total expenditure 58.91 to 11.98 billion yuan on the eastern part of central hospitals, the combined expenditure 180.41 to 25.517 billion yuan on general hospitals; the total expenditure 20.62 to 3.816 billion yuan on the central region, spending to 8.435 billion yuan for 47.92 on the total of general health hospital; western regional centre for hospital expenses is total of 8.185 billion yuan to 39.87, the combined expenditure is 9.318 billion yuan to 56.90 on general hospitals; the total of expenditure is 404.63 billion yuan to 672.51 billion on township hospitals nationwide2. Estimating the balance of payments in accordance with the middle level of expenditures (50%) on the township hospital, the income and expenditure balance of 6.866 billion yuan , such as better invested in accordance with the level of expenditures (75%) to compare, Negative balance of payments for 13.036 billion yuan, with the additional financial should be input at least 13.036 billion yuan.3. According to Study on the full implementation for township hospitals of the Ningxia Hui Autonomous Region is found that: the implementation of full funding is conducive to stability hospital personnel and reduce the burden on hospitals. Drugs three unified policy to reduce the drug prices. There have same main question: First, medical institutions of control is too stringent, so that there are have been empty for the overall medical institutions and personnel are serious ageing, county-level medical institutions Serious brain drain. Second, the enthusiasm of the medical staff is not high, there are lack effective incentives. Third, the local government is inadequate attention to preventive work, the preventive treatment's wages is low, the ranks is instability. Fourth, the "four exam" system is unreasonable, the employer have no autonomy.4. Anlysis the pilot areas related policies and measures of the implementation of diveded income and expenditure on township hospitals is found that: the fund management system of township financial "rural counties of Finance" is enabling the norms of the hospital's financial management, and also avoided uneasonable expenses and misappropriation funds. the main disadvantage is that hospitals without the autonomy of the funds, the hospital's development is to be strict restrictions by the financial management of county agencies.5. According to anlysis the policies and measures of divided income and expenditure on the community health care institutions is found that : the workload of staff is measuer through a standard to measure, the disrtribution of income is reflect through the performance appraisal, Institutions of the public welfare is to be reflect by zelor of drugs and slip, There have disadvantages and beneficial above the three measures . First, the standard volume of practical is difficulties. Health workers is difficult precise and scientific calculations to carry out. Secondly, the performance pay system could lead to additional induced demand and the increase in volume. Finally, the market's resistance is larger on the drugs "zero interest rate differential" and also there are shortages of essential drugs and it's lack of policy support.6. There were some main problems on the implementation of divided funds management of incomes and expenditures in Township hospitals. First, the personnel management system was incompatible with the separate management of incomes and expenditures. the hospital president was appointed, so that there was lacking of incentive and restraint mechanism to them, which was not conducive to the operation and development of hospitals.Second, the current financial management was mess, and establishing an effective fund supervision mechanism was badly needed. Third, the annual budget was difficult. Fourth, , the operating efficiency was low, and the idle and insufficient allocation of health resources co-existed. Fifth, it is unclear responsibilities and investment ratio has not yet been determined of governments at all levels,so that, the long-term funding mechanism and effective protection is lack . Sixth, the model of divided funds management of incomes and expenditures involving multi-sectoral interests and needs of the multi-sectoral cooperation and support, especially it is need support of financial departments at all levels.Conclusion:To sum up, this article holds that the mode of divided funds management of incomes and expenditures in township hospitals was feasible as to the current financial supporting capacity of the government, and the divided funds management of incomes and expenditures was feasibily, Results of the pilot areas showed that the township hospital divided income and expenditure management have also made certain achievements for the promotion of the development of rural health services, despite of the process of capital management still exist some problems. Therefore, the paper that the divided of income and expenditures within capital management model in township health centers is the possibility, but considering our current health care management system and operational mechanism, there were still calling for some appropriate support systems, the relevant supporting policies and health management system .Recommendation:1. It should be reformed the personnel system and implemented national engaging or contract management system, at the same time, pushing position competition and the year-end assessment in township hospitals 2. Strengthened the construction of the township hospitals, including the basic medical devices and personnel trainings. For example: bringing the infrastructure construction into the budget, establishing the regularly counterpart assistance system, providing the special training for specific skills periodically.3. Government should afford the total operating funds of the township hospitals and establish the long-term financial security mechanism to assure the implementation of the divided management of incomes and expenses4. Referring the successful experiences of the divided management patterns of incomes and expenditures in community health service institutions, such as performance appraisal system and drugs "zero interest rate differential" system, and so on.5. It should introduce the market competition mechanism and enhance the operating efficiency of agencies, at the same time, the government may encourage private capitals inputting and the shareholding system implementing, meanwhile give preferential tax policies.