| 1. ObjectivesSince the launch of medical and health system reform, in2009, to establish a scientificand effective evaluation index system of the core value of public hospitals, according to thehospital’s overall development plan and target, the core of public hospitals at various levelsand value evaluation, timely find problems and amended, for the social public to providesafe, effective, high quality and convenient medical service, scientific and reasonableutilization of health resources, has become an imminent issue.With literature analysis and theory research, this study defines the conceptualframework of the balance between public welfare and efficiency core values in publichospitals, and selects the alternative index of the core value in the public hospitals. Then,through expert consultation method, the index system which is based on balance betweenpublic welfare and efficiency of the core value of public hospitals, suitable for China’snational conditions, is filtered. Besides, take the public hospitals at the county level forexample, China’s public hospital public welfare and efficiency at the county levelcomprehensive evaluation level, analysis main influencing factors of different types of corevalue of public hospital and the specific path of ascension, aiming at providing theoreticalbasis for our country public hospital reform work and policy reference.2. Research programs(1) Defining the core value of public hospital conceptual framework;(2) Constructing a evaluation index system of the core value based on the balancedpublic welfare and efficiency in public hospitals;(3)The core value of public hospital evaluation results and the analysis–taking thepublic hospitals in county level for example;(4) The construction strategy of the core value in public hospitals3.Methods (1) Literature analysis: Searching the literature of the public hospital public welfareand efficiency from China journal full-text database (CNKI), China science and technologyperiodical database (VIP), PubMed, OVID, ScienceDirect,etc, constructing preliminaryestablishment of index system for the core value of public hospitals.(2) Expert consulting: Selecting the expert for consultation, from institutions of higherlearning, administrative departments for public health, health service agencies, constructingpublic hospital public welfare and efficiency balance to give priority to the core values ofindex system.(3) Taking the public hospitals at county level for example, to sample the publicwelfare and efficiency of hospital comprehensive index clustering analysis of hospitalgroup structure characteristics of the formation of cluster analysis, and formed four majortypes.(4) Interviewing: a social investigation further insider depth interview method wasused to obtain and supplement the opinion and suggestion on the evaluation of the corevalue of public hospital.4. Results and Conclusions(1) Based on286samples of public hospitals at the county level are the core valueevaluation, according to the public welfare and efficiency index sorting, classifiedaccording to quartiles, the top25%of the county-level hospitals, the east has26(the most),central25, in the west is20(the least).(2) Fractal evaluation sorting result is: the central and western regions of the countyhospital public welfare scores are relatively good, the eastern region public welfare score isrelatively weak; In eastern and central parts of the county hospital efficiency scores arerelatively good, efficiency score is relatively weak in the west.(3) Cluster analysis showed that the eastern region and central region comprehensiveevaluation result is relatively concentrated, the western region of the evaluation results withthe former two gap is larger. (4) Characteristic comparison results for among different groups, the eastern region inpublic hospitals at the county level in the core values of the evaluation results for low andmiddle public welfare, efficiency, and high comprehensive; Central parts of the core valuesof public hospitals at the county level evaluation results for high public welfare, lowefficiency, high comprehensive; In the western region the core values of public hospitals atthe county level evaluation results for the public welfare, medium, high integratedefficiency.County hospital to sum up, the sample is given priority to with balanced publicwelfare and efficiency of the core value of the evaluation results, and parts of eastern,central and western three economic development level, the health resources distribution, thedensity of population structure has a close relationship.5.Recommendations（1）By each group and each dimension score sequence analysis, put forward "highpublic welfare-low efficiency","low public welfare-high efficiency type ","low potential-low public welfare and low efficiency type " and "balanced type-high public welfare andthe high efficiency type" four kinds of main types.（2）Putting forward the construction according to different types of public hospitalpublic welfare and efficiency balanced strategy advice.（3）Combined with actual situation existing in our country, proposing policysuggestions to promote construction of the core value in public hospital from thegovernment, hospitals, social three angles.6. Innovations and deficienciesInnovations: This study constructed on the basis of relevant theoretical research ofpublic hospital public welfare and efficiency of the core value of the equilibrium conceptmodel, and the corresponding index system, and thus puts forward the realistic andoperable promoted the implementation of the core value of public hospital path and strategy,has the larger policy induced and practical application value. Disadvantages: Due to the specificity of the various types of public hospitals at alllevels, the universality of the evaluation index system will be affected by certain influence;This study requires strong clinical theory knowledge and practice experience, theresearchers the judgment of the hard to avoid has certain limitation, lead to the deviation ofthe evaluation results. |
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