Study On The Evaluation Of Management System Reform Of Public Hospitals

ObjectiveThrough the research of cities’ public hospital reform, comprehend fundamentalreform of public hospital management practices, on the basis of various areas’practices, summary public hospital management system implementation modelssuited to China’s national conditions; combination overall requirements of deepeningreform, we analysis the effect of the management system reform of public hospitals,then provide suggestions and recommendations to formulate specific measures forthe reform of public hospital management system.Materials and MethodsThe research combinations quantitative and qualitative methods, throughquestionnaire investigation and personnel interviews, summary the implement resultsof public hospitals’ management system reform in the past year.According to thisstudy of stratified sampling method, choose30public hospitals from participation inthe reform of public hospitals in Eastern, Central and Western cities, in the form ofquestionnaires collecting hospital data indexes from2008to2010. The main indexesof analysis included hospital revenue and expenditure, income structure,efficiency ofmedical services in hospitals, number of medical services, hospital costs,asset-liability ratio, and so on. Using SPSS17.0statistical soft-ware to descriptivelyanalysis data, using two independent samples t-test to take statistical analysis.Results 1Provide an overview of public hospitals’ management system reform mode. On thebasis of the conclusion of actual reform, according to the relationship with healthadministrative departments, summary public hospitals’ management system reforminto four different modes: Committee of management mode, Hospital managementmode, Health administrative departments "pipe-run" mode and Hospital developmentgroup (company) mode.2Analysis two properties of public hospitals’ management system reform mode.Public hospitals as institutions act the Government protect people’s health interests,at the same time as the main body of market economy in modern hospital system,with social property of social welfare objectives, as well as nature property ofeconomy development. An important indicator of management system reform ofpublic hospitals, is to balance the relationship between two properties, both throughthe introduction of market economy rules and a modern management system, toimprove medical service quality and level to keep hospitals health sustainabledevelopment, and act social functions, to implement non-profit management goals,controlling medical costs and rapid growth. This research through the expert review,integrate assessment different modes with "development index " and "publicwelfare index", by the tendency of size for sorts, quantify sort order of precedence,on the basis draw the "value tendency of public hospitals’ management reform ".Hospital management mode and Hospital development group(company) modedevelopment with natural property, Committee of management mode and Healthadministrative departments "pipe-run" mode development with social property.3Analysis date indexes with two properties sample hospitals. According to stratifiedsampling method, choose30samples in the public hospitals participate reform inEastern, Central and Western cities. Divide30Sample public hospitals into natureproperty dominated public hospitals and social property dominated public hospitals,and analysis indicators of two sets in sample hospitals.3.1Hospital revenue and expenditure comparison. In the hospital’s totalincome,business expenses,revenue per doctor and revenue per bed, nature propertydominated public hospitals’ revenues are higher than those of social property dominated public hospitals’.In the efficiency of fund utilization, nature propertydominated public hospitals’ efficiency is higher than that of social propertydominated public hospitals, and possess greater development capacity.3.2Hospital revenue structure comparison. To the nature property dominated publichospitals is lower than the social property dominated public hospitals in financialassistance income accounted for the proportion of the total income of the hospital.Higher than the income of public hospitals based on social attributes drugs accountedfor the proportion of the total income of the hospital in the proportion of drugrevenues in the total income of the hospital, the natural properties of the main publichospital drug income accounted for the proportion of the total income of the hospitalThe medical proportion of the total revenue, the two group of hospitals were nosignificant differences.3.3Efficiency of hospital services comparison. Average annual outpatient visits, perdoctor annual outpatient visits and the average annual number of inpatients in thehospital, nature property dominated public hospitals’ annual average number ishigher than that of social property dominated public hospitals. In Inpatient surgerytimes, the number of nature property dominated public hospitals is higher than that ofsocial property dominated public hospitals. This shows that the nature propertydominated public hospitals are more efficient than that of social property dominatedpublic hospitals in service.3.4Hospital costs comparison. In hospital outpatient per cost, inpatient per cost andthe costs of per hospital bed days aspect, nature property dominated public hospitalsare higher than those of social property dominated public hospitals. Description tonature property dominated public hospitals’ hospital costs are higher than that ofsocial property dominated public hospitals, so resident in nature property dominatedpublic hospitals heavy burdens on the social property dominated public hospitals.Discussion and SuggestionsNature property dominated public hospitals’ development power greater thansocial property dominated public hospitals, hospital asset value faster, with thehigher efficiency and higher service charges. But as a commitment to social functions of public welfare medical institutions, nature property dominated publichospitals led to the residents and expensive. Government should strengthen thehealth cost of inputs, control the speed and scale of the development of publichospitals, to control the growth of medical costs, and reduce the people see a doctorafford. social property dominated public hospital charges are lower than the natureproperty dominated public hospitals, hospital income, increasing the value of assetsweak, single-run medical system difficult to adapt to the environment of the marketeconomy, but at the same time the efficiency of the service is also lower than thenatural attribute-based public hospitals, residents in the social property dominatedpublic hospital will encounter a medical treatment is difficult problem.Public hospitals as a social welfare organization to shoulder the responsibility toimprove the quality of the entire national health, and its decision-making anddevelopment should consider the needs of society and social benefits. For publichospitals, it is an economic organization, attention to social benefits, not only canestablish a good social image of the medical institutions, access to the broad supportof society in the pursuit of economic interests, for their own to create a broadersurvival and space for development. Therefore, put forward the following proposals:①Clear the management system and elements in public hospitals;②Clarify“separate management and operation” and “separating the functions of governmentfrom those of institutions” in public hospitals;③Different public hospitalmanagement system reform model have different suitable conditions;④Differentattributes of public hospitals should adopt a different approach to reform;⑤Stick toprinciples, to ensure the reform of the normative system to promote.