Study On Influencing Factors About The Level Of Financial Compensation In Public Hospitals

ObjectiveBased on understanding of the compensation of public hospitals in our country and theoperation and compensation situation of public hospitals in the sample areas, along withusing statistical methods to analyze the financial compensation and to identify the keyfactors about the level of financial compensation of public hospitals in the sample areasnow, and qualitatively analyzing the related factors about the level of financialcompensation through literature review and key informant interview, explore the problemsin the financial compensation of the public hospitals, learn the theory and experience ofdomestic and foreign public hospitals in financial compensation, and put forward therelevant recommendations to improve the public hospital financial compensation bycomparing the empirical research and qualitative analysis.Methods1. Documentary ResearchReviewing and collecting the relevant domestic and foreign literature on thedeveloping and compensation situation of public hospitals to understand the government’sfinancial investment policy and direction, as well as the financial compensation level, scope,channels, methods and impact factors of public hospitals.2. Field InvestigationIn accordance with the random sampling method and according to our differenteconomic levels and regional distribution, we siphon six provinces (Guangdong, Zhejiang, Hubei, Hebei, Guizhou, Gansu) from the east, middle and west areas, and we randomlyselected5public hospitals from each province(total30hospitals) as study sites.Design health administrative departments’ questionnaire, in order to know thesocio-economic development, the population status, government health spending, and thefinancial compensation constraints in the case of sample areas. Design public hospitalsquestionnaire, to seek information on the income and expenditure of the hospital, hospitaloperators and other related issues.3. Insider depth interviewsInterviews, the person in charge of relevant departments, to know the current situationand development prospects of the reform of public hospitals from the overall understanding,to explore the problem of the existence of financial compensation, factors affecting thelevel of hospital financial compensation and the way of financial compensation, etc.4. Statistical MethodsUsing descriptively statistics analyze government health spending status, publichospitals income and expenditure, the hospital financial compensation status and thehospital operational status. Applying the rank sum test and multiple linear regressionanalyze the factors affecting the level of financial compensation in public hospitals.Results1. The situation of financial compensation for public hospitalsThe level of financial compensation kept increasing, but financial assistance accountedfor the proportion of the total revenue of the sample public hospital was always less than10%, and drug income accounted for the proportion of the total revenue continued to morethan40%from2008to2011. The level of financial compensation in average secondaryhospitals was much lower than the tertiary hospitals, and the level of financialcompensation for the central region of the hospital was not only lower than the easternregion but also lower than the western region. Hospital’s recurrent expenditure that wasbasic expenditure has no large changes, but special spending increased more obviously. 2. Empirical Research on the Influencing factors in the level of financial compensationMultiple linear regression analysis showed that the size and operations of the hospitalwere the main factors affecting the level of financial compensation of public hospitals. Thelarger the hospital, the higher level of financial compensation; Better operational status ofthe hospital was, the lower the level of financial compensation stayed. Currently,government financial investment to public hospitals was based on these instructionsindicator of the size of the hospital, like beds, personnel, etc.3. Qualitatively analysis of the Influencing factors in the level of financial compensationCurrently, influencing factors considered when determining the level of financialcompensation in public hospitals was more single. It will improve the rationality andscience for the distribution of financial compensation if government comprehensivelyconsidered the Influencing factors in the level of financial compensation from the macrolevel of social, economic, demographic and micro-level of hospital’s level, category,amount of medical services, quality of service, service efficiency, hospital size, cost control,social responsibility and scientific teaching.Conclusion and suggestionsThrough the field research data analysis and literature analysis, it indicates that thereexist some problems for financial compensation of public hospitals:(1) The amount offinancial investment from government is not sufficient.(2) Influencing factors about thelevel of financial compensation considered by government is one-sided.(3) The allocatingof financial compensation is unscientific.(4) The financial compensation structure isirrational and with a narrower.(5) The standard of financial compensation is unreasonableand the method is single.Reference to financial compensation experience in foreign hospitals, combined withthe current problems in financial compensation in our public hospitals, this paper putforward several following suggestion:(1) Analyzing Influencing factors about the level offinancial compensation from multi-angle, and reasonably determining the level of financial compensation.(2) Adjusting the structure financial compensation and improving thecompensation package;(3) Clearing the compensation standards and improving the way ofcompensation;(4) Coordinating the interests of many parties, to promote rationalization ofthe compensation.Innovations and DeficiencyInnovations：Currently，most of the research on financial compensation for publichospitals concentrated in the compensation channel, the compensation range and otheraspects, few studies focus on influencing factors about the financial compensation in publichospitals. In this study, statistical methods and insider depth interviews were used forempirical analysis and qualitative research, more comprehensive analysis of the level offinancial compensation for public hospitals, to lay a foundation for improving the financialcompensation standard and compensation measure research in public hospitals.Deficiency: The number of different levels of hospitals in sample areas is notconsistent, so the empirical results might be caused by it. The empirical research mainlyfrom the angle of the hospital’s own situation, and did not fully consider thesocio-economic, demographic, health policy and other differences between differentregions, and there may be some bias in findings.