| BACKGROUNDSCounty hospitals as the medical centers, medical services and technical guidance centers, medical research and teaching bases in the whole county, their service cover 80 percent of the rural areas. Their functional orientation is to provide health services for the residents within the county and to solve the local people’s "cost of medical care’" problem. County hospital reform is one of the highlights of new health system reform, whether it operation status is good or not concerns the development of our country’s health career."CPC Central Committee and State Council on Deepening the Views of Medical and Health System Reform" was issued in 2009, it illustrates clearly that "we should further improve county hospitals as a leader, township hospitals and village clinics based rural health service network". "Guidance on the Reform of Public Hospitals" was issued in 2010 and point out that "we should promote the standardization of county hospitals and improve their business premises and equipment. Improve urban and rural hospitals counterpart support system, multi-form and multi-channel to strengthen the development of qualified personnel, and improve the quality of personnel and ability levels of county hospitals gradually." Opinions on Promoting the Comprehensive Reform of County Public Hospitals" was issued in 2014 and it point out that "we should adhere to the principles of basic security, strong grass-roots and building mechanism and the public nature of public hospitals. To break with medicine supply medical mechanism as the key point, more attention should paid on systematic, integrated and collaborative of the reform. We should put more emphasis on institutional innovation and governance systems and institutional capacity-building, and to the root cause symptoms, overall progress and key breakthroughs in unity, deepen comprehensive reform county public hospital management system, compensation mechanisms, the price mechanism, drug procurement, staffing, income distribution, health care system, and the regulatory mechanism. "In order to meet the urgent requirements of Shandong province, this study collected, sorted and analysis 126 county hospitals’data of economy in recent years. Understanding the amount of medical care in the county hospital services under the new health care reform background, health service efficiency, balance of payments, medical expenses, the burden on patients and other economic conditions, summarizes a useful experience in new health care reform process and to analyze the difficulties and problems for healthy economic development in Shandong Province County Hospital to provide ideas and measures and programs to provide the basis for health administrative departments to further promote hospital reforms.OBJECTIVESAccording to the economic data collected, sorted and analysis in 126 county hospitals" (the First People Hospital) data of in years of 2009-2013, we describe the situation of the operation status and evaluation of county hospitals. We also divided Shandong province into eastern, central and western regions due to their economic development and made comparison within the whole province. Under the background of new medical system reform, understanding county hospitals of their economic situation like medical services, medical service efficiency, balance of payments, medical expenses, patients burdens. Summarize the countermeasure and suggestions to the healthy development of county hospitals in Shandong province in order to provide scientific basis and train of thoughts to further reform and development.METHODSData of this study is from hospital financial annual reports system in 2009-2013 of health statistics information center in Shandong province. In accordance with the administrative area of Shandong province, we chose 126 counties’first people’s hospital in Shandong province as the study. Use Delphi expert consultation method and literature research to select the economic index of health services, health service efficiency, balance of payments, medical expenses and patient burden. SPSS 16.0 is used to perform statistical description. By the comparison analysis among eastern, western and central areas’county hospital in Shandong province, we studied the changes in health services, health service efficiency, balance of payments, medical expenses and patient burden. The methods we used include literature review, Delphi expert consultation, descriptive analysis, ratio analysis, comprehensive analysis and comparative analysis, etc.RESULTS1. In the process of reform, county hospitals in Shandong province has achieved some success as decline of medicine proportion and relief of using medicine to fill up medical incomes in 2009-2013.2. The absolute value of a number of indications increased year by year, the per-capital income/expenditure also increased accordingly in county hospital of Shandong province in 2009-2013.3. County hospitals’cost at average and increase of medical expenses are effectively controlled, burden of patients is relieved also during 2009-2013.4. The absolute value of medical service quantity in county hospitals has increased and medical service ability has improved year by year during 2009-2013.5. The debt situation of county hospitals in Shandong province has expanded in 2009-2013, but all the three regions’debt paying ability has to be improved.CONCLUSIONS AND SUGGESTIONS In accordance of the operation status analysis of county hospitals in Shandong province during 2009-2013 and reform measures suggested under the background of the new medical system reform, suggestions are proposed as follows:1. The scale of county hospitals should be strictly controlled to avoid blind expansion and liabilities increased in financial risk.2. Strengthen the government’s financial investment, reduce investment gap between different areas and improve the government compensation mechanism.3. Adjust medical service price and strengthen the county hospitals medical service price management.4. Further improve the construction of talent team and vigorously promote the reform of county hospital personnel and distribution system. |
PDF Full Text Request