| To investigate and analyze status in the field of Health, the external and internal environment of hospital by SWOT Analysis, before and after the merging and restructuring of Tongde Hospital of Zhejiang Province . To afford evidence to the decision making for merging and restructuring, to analyze the situation of hospital management, in quantity, to evaluate the effect of implementation of SWOT strategy . To provide evidence for reform of other public hospitals and for government to make decision . [Methods] SWOT Analysis was conducted on 3 hospitals before merging and on Tongde Hospital after merging . The results before and after merging were compared. SWOT strategy was applied to guide the pattern and procedure of merging . Multi-stage principle was applied to analyze average serving numbers, working efficiency, economic efficiency, capital efficiency, costs, rank among TCM line in Zhejiang province , etc . Increasing rates were calculated before and after merging . Implementation results of SWOT strategy were evaluated by performance after merging . [Results] The advantage of hospital after merging become remarkable, disadvantage was overcome or compensated, opportunities increase, while threatens decreased . And after merging, the hospital serving ability is enhanced, serving scope is enlarged, numbers of serving objects are increased . The average outpatient numbers increased from 108.47 before merging (in 1999) to 268.33 in the merging year (in 2000), increasing rate at the same stage was 147.4%, later increased progressively every year, and reached 728.86 in 2003 .The average inpatient numbers increased from 1.97 before merging (in 1999) to 2.13 in the merging year (in 2000) . Increasing rate atthe same stage was 8.1%, later increased progressively every year, and reached 9.14 in 2003 . Medical efficiency was raised after merging too: bed circulation rate increased from 59.05% before merging (in 1999) to 59.50% in the merging year (in 2000), increased by 0.8% at the same stage , later increased progressively, and reached 98.85% in 2003 . The average hospitalization duration decreased from 28.65 days before merging to 26.15 days in the merging year (in 2000 ), decreased by 8.7% at the same stage, later decreased remarkably, and decreased to 14.54 days in 2003 . The difficulty situation of former 3 hospitals has been changed, property employing efficiency was enhanced, costs were in good control, labor production efficiency was raised, worker's welfare was also improved . Income and expense balance was negative (RMB $-2,499,000 ) in 2000, while in 2003 it was 19,690,000 . The average business income increased from RMB $48,000 before merging (in 1999) to RMB $75,000 in the merging year (in 2000), increased by 56.3%, later increased progressively every year, and went up to RMB $238,000 in 2003 . Average personal expenditure increased from RMB $15,600 to 21,900, increased by 40.4%, later increased progressively, and reached RMB $54,000 in 2003 . While cost percentage in income decreased remarkably every year , from 108.85% in the merging year down to 87.43% in 2003 . Ranks in Zhejiang Team line went up quickly from the 30th to the 4th . This can explain the social position and reputation has been promoted and comprehensive competitivity has been strengthened . [Conclusion] SWOT analysis is the positive attempt and exploration on strategic management of hospital . The reform plan for merging of Tongde Hospital is correct, and also successful. The pattern and procedure for merging is feasible, and also appropriate . Public hospital reform should actively explore reform of personnel system, allocation system to activate internal operating mechanisms, while government should change its function, administration and management should be separated, government should give policy support to hospital to promote sustainable development of medical facilities . |
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