Study On The Managerial Model And Operational Status Of One Hospital Group In Shanghai

[Background]:For a long time, China's regional high-quality medical resources being concentrated in large hospitals while resources being idle in basic level hospitals and structural problem being existed in regional medical service supply system that triggered the issue "medical care, medical treatment is difficult and expensive" has become the major social conflicts. Integration of resources between state-owned hospitals and hospital groups setting up could optimize the allocation of health resources and improve efficiency in the use of health resources and release the "medical care, medical treatment is difficult and expensive" issue. Since the 90's of the 20th century, our major cities began to explore the integration in big state-owned hospitals. Since Year 2000, the government has promulgated a series of supporting policies, documents in order to encourage various medical institutions to cooperate and integrate. Driven by these policies, a number of hospital groups and hospital complexes have been established rapidly. Meanwhile, the integration of the state-owned hospitals has also been carried out actively. Those groups include Ruijin Hospital Group and No.6 People's Hospital Group and other big complexes.Hospital group in China is still in the growth and development, which triggered a new research topic. Reviewing from the previous research collected, currently domestic scholars have focused on the hospital groups much remain in the theoretical level, but little empirical study. In this study, the realistic issues during the operation of the hospital groups will be mainly focused combining with my own daily work and the status of one hospital group in Shanghai and its first-hand information. Therefore, this paper has high empirical research findings with strong operational recommendations.[Aim]:The aim of this research is to explore the theoretical and empirical analysis on a well-known hospital group in Shanghai. Through vertical integration, hospital management background analysis, operational status description, running obstacle analysis, summarize the problems of medical resources and vertical integration and appropriate model, initially propose integration model, policy ideas, strategies for medium-sized hospital group. It provides reference in the aim of further scientific and vertical integration for big and medium-sized hospitals in Shanghai even the whole country.[Contents and Methods]:In this study, through research paper review and data collection, hospital questionnaire survey, government departments manager and inner group's interviews with hospital heads, following the development and operation of one hospital group's integration in Shanghai, there are three related contents being studied:First is the background of integration of hospital group, the joint model and management system and the distribution of benefits among the hospital inner group. Second is the government protection and controlling mechanisms and internal safeguards while the hospital group operation. Third is the hospital group operating results, including the establishment of the group and before, and people, financial and material resource situation; the quality, quantity, efficiency and expenses of health care service in hospitals, as well as the hospital's medical education, research and academic building status and other changeable objective data and hospitals affiliated to the regional health board leadership and ones in the hospitals and finally the subjective evaluation of running the hospital group from the medical staff collected randomly and middle management of the hospitals.[Results]: This study found that hospital groups in the survey were in a cooperative business model, and which establishes a certain internal and external security mechanism. A clear strategic development objective has been established; the hospital groups are running effectively; human, material and financial resources of the core hospitals and its members have gone through a certain development as well as hospital medical service quantity, quality and efficiency and cost situation and medical education, research and academic building status. But comparing with the average index in Shanghai or China, the overall effect is not significant. At the same time, it is also not fully recognized by government departments, hospital management and staff.[Discussion and suggestions]:The empirical research showed that the hospital group is an important future direction of medical innovation. The hospital groups investigated did not bring the expected effect is mainly of the following reasons as concluded: Firstly, both the current fragmentation of health resources and the "two-stage finance, second management" system bring a certain amount of institutional barriers to the integration of public hospitals. Secondly, the failure of "assemble but not unite" to lead to scale effect is resulted from the lack of corresponding management support for the governance structure. Thirdly, the government supported policies are in an imperfect situation. Fourthly, the core competitiveness of the core hospitals is not being further strengthened. Lastly, group's medical strategic development model still remains to be improved.Strategy proposed in this paper suggested that current management mechanisms and operation structure should be improved so as to set up a hospital group more closely and current strategic medical model of the groups should be shifted into model "large specialized with small integrated" for core hospitals and model "large integrated with small specialized" for member hospitals. The rest advices include that the hospital group should be built on the government-led basis, the medical resource and interests of administrative regions should be integrated, the medicare payment polices should be adjusted, and the current unitary hospital group model should be changed accordingly.The innovation of this paper is mainly on the following aspects:Firstly, a great deal of empirical research has been put into this paper, of which business type and operation model of the hospital groups and its resources and market share, as well as its competitiveness and operational effectiveness and its existing problems. It made up the shortness that much theoretical analysis and inadequate empirical research in the precious research.Secondly, the strategy proposed could be highly carried out and some with its originality that have already been put into practice.