Study On The Government Regulation Mechanism Of Hospitals In Wuhan Metropolitan Area

ObjectiveOut of the status of the hospital regulation mechanism in Wuhan Metropolitan Area, found its insufficiency and the cause. Combined with the ideas of health system reform in our country and the construction policy of the Wuhan Metropolitan Area, we made this research to put forward a proposal to improve the hospital management in Wuhan Metropolitan Area and provide theoretical as well as empirical references for constructing and improving the government regulation of the hospital mechanism, promoting the health system reform in Wuhan Metropolitan Area.MethodsWe made this study by means of sociology, management and statistical theory and method, combining the theoretical analysis and empirical research. Main methods include○1 Document analysis: to review and summarize the domestic and foreign hospital regulation theories and experience;○2 Field research: include questionnaires and interviews with informants;○3 Expert consultation: hold an expert seminar to discuss the views and suggestions of this study;○4 Statistical methods: use descriptive statistics, correlation analysis and rank-sum test to analyze the results of the survey; use TOPSIS and RSR to analyze and evaluate the quality as well as economic operation statistics of the sample hospitals;○5 Cause-effect analysis: use cause-effect analysis to decompose the reasons and influencing factors of feeble regulation.Results1 The medical development is imbalanced in Wuhan Metropolitan Area. The distribution of the medical resources is not unified, most of which is concentrated in Wuhan. There is significant difference in the situations such as the service quality, the income and output of the medical institutes and the average medical expense among the nine cities in the cycle. The convenience of metropolitan has not been played very well to exchange and study among the organizations of the 9 cities. 2 There are problems in medical service market of Wuhan Metropolitan Area, such as doctors practicing medicine without a license and so on. There is an urgent need to explore and perfect long-term medical regulation mechanism under the new environment of Wuhan Metropolitan Area.3 Through the interviews with leaders of the government regulation organizations and the hospitals in the nine cities, we learned that the government and hospitals were actively exploring methods to develop medical market and hospitals. But there were still some problems in the regulation system and mechanism, such as that government had no real authority, the regulation method insufficiency and so on.4 By analyzing the collected 539 questionnaires, we found that 92.8% of the respondents thought the government needed to strengthen the regulation in the hospital service quality and economic operation, or at least one aspect to be strengthened; 76.6% of the respondents considered that the reasons for regulation insufficiency were the'relevant laws and norms are not perfect; there is a lack or inadequacy of supporting rewards and punishment measures'and'the lack of perfect long-term regulation mechanism as well as discontinuity in the management'; 66.0% of the respondents thought if the government regulation of hospitals was not appropriate, hospital's daily operation would be influenced.5 Evaluate the quality and the economical operation performance of the sample hospital with the TOPSIS and the RSR method. We found that some hospital located at the same city but make a great difference in performance. It indicated that hospital quality and economical operation not only have business with government regulation, but hospitals own management also played a major role. The government regulation department and each hospital have the necessity to do some adjustment and improvement based on the performance evaluation results.Suggestions1 Improve the role of government in the hospital regulation: perfect relevant laws of regulation; enhance the long-term action of hospital regulation; concern about the efficiency; improve the implementation of regulatory mechanisms for hospitals; guarantee the government regulatory power; improve inter-agency coordination and interactivity in metropolitan and so on.2 Upgrade the hospital self-management level: cooperate with government regulation; increase communication with patients, and promote mutual understanding; make clear hospital development goals; carry out standardized and scientific management of the hospital.3 Lead non-government social forces to participate in regulation: the media should improve the social responsibility and report the medicine related news realistically; medical intermediary organizations (such as medical associations) should display their professional knowledge to participate in supervision and management of the hospital.