Research On The Appropriate Size Of County Hospitals In Anhui Province

Objective: The role of county hospital is very important. On the one hand, county hospital is gathering great and valuable health resources; the other hand, the county hospital is a medical technology center of rural health care network, taking up important and difficult responsibility of medical services. The appropriate using of the function of county hospital is closely related to their appropriate size, the insufficient scale and the excess scale will lead to serious consequences. At present, there is still many problems exist in the scale construction of our country hospital. So it will have an important and real significance to research and design the quantitative forecasting model of the county hospital's appropriate size, which can lead to a healthy development of our country hospital. There are two purposes of this research: First, bring up a simple and appropriate mathematical model that determined an appropriate size of country hospital; the second, design a auxiliary tool for users to plan the county hospital scale.Methods: This research comprehensive used methods such as reviewing of the literature and information, consulting with experts, surveying, soft systems analysis, Date Envelopment Analysis and so on , carried out a series of research activities, around defining the indicators of scale, analyzing the factor of scale, building measure model of scale, developing auxiliary measurement tools of scale.Results: (1) Selected out a set of relatively objective and accurate system of key indicators of the size of the county hospital; (2) Form a conceptual framework including the service population, medical needs, medical demand, medical decisions; (3) Constructed a series of calculation model from simple to complex; (4) Designed a auxiliary tool of simple and practical; (5) Used the predictive model to predict the size and structure indicators of county hospital in 61 counties in Anhui Province.Conclusion: (1) Although the impact factors of the size of county hospitals complicated , but it can be summarized in two aspects of demand and supply factors. The most important variable in demand is the total population and its components, and the impact of the supply is reflected in the volume of services at all levels of medical institutions; (2) The key indicators which responsed the size of the county hospital, such as the total number of outpatient, the patients, hospital beds, staff, it can be a reference for the health administrative departments when they establish the hospital evaluation system; (3) From the analysis results, the number of hospitals which scale increasing are twice the number of hospitals which scale decreasing, that it is necessary to expand the scale of the county hospital and control the number of county hospitals; (4) Status survey suggests that some of the grading requirements for county hospitals (Secondary Hospital), and there was the tendency to increase the size of the county hospital, managers in the planning of the scale of County-level hospital is not required to pay special attention to the level of the hospital, but should be pay attention to the real needs of local residents, only by this way, can it effectively avoid the waste of valuable health resources; (5) The scale of the county hospital is not appropriate to the health services market demand in part of the economic underdevelopment, less populated, remote areas, so how to improve the utilization of health resources in these areas is the need for further research and exploration.