The Research On The Operation Conditions Of Non-public Hospitals In Changning District, Shanghai

BackgroundAdhering to the principle of public medical institutions-led development and co-development between publican non-public medical institutions, stimulating the formation of diverse medical pattern is the basic principle and fundamental direction of the structural reform of health care system. To encourage and guide social capital to establish medical institutions is conducive to increasing health resources, enlarging supply of health services and meeting the multi-level, diversified demand of people. Non-public medical institutions not only participate in the competition in the field of public health, but also further promote the process of health reform and help establishing a sound health system at the same time. In 2010, the general office of the state council issued the notice about the opinion on further encouraging and guiding social capital to establish medical institutions and the ministry of health issued the notice about working better in setting, approval and management of non-public medical institutions. These notices put forward the instructions on expanding market access for nongovernmental investors to establish medical institutions appropriately, determining the reasonable scope of practice of non-public medical institutions, strengthening the operational guidance and supervision on the non-public medical institutions.Objective:To identify and analyze the influence factor of non-public hospitals’ normal operation and standard practice by investigating the operation conditions of non-public hospitals in Changning district. To summarize and evaluate the key points of non-public hospitals methods to promote good operation and standard practice. To provide suggestions for how to perfect non-public hospitals’ plan and admittance standards, to guiding the benign development of the non-public hospitals and to increase the supervision efficiency of non-public hospitals.Methods:Both quantitative and qualitative methods were applied. Investigating 18 non-public hospitals in Changning district which obtained Practice License of Medical Institution before December31,2011 by using quantitative and qualitative methods. Collecting statistical materials such as Changning Health Statistical Yearbook, records of health administrative penalties and bad practice of scores. Identifying the influence factor of non-public hospitals’ operation and provide suggestions for the non-public hospitals by descriptive analysis and comparative analysis.Results:10 general hospitals and 8 specialized hospitals in Changning District were investigated in this study. After a period of rapid development, the development of non-public hospitals is gradually slowing down in recent 5 years. There are mainly for-profit hospitals in these 18 non-public hospitals. The structure of the amount of registered capital of the non-public hospitals are like a pyramid and the structure of the total investment of these hospitals are big in the middle and small at both end and are like an olive. The amount of approved beds and open beds of the non-public hospitals are low and the amount of open beds of the non-public hospitals only account for 8.21% of the total open beds in Changning District. From 2009 to 2011, the operation situation of the non-public hospitals is better, the profitability is improving and the non-public hospitals are going in the right direction gradually. However, the outpatient amount of the non-public hospitals only account for 4.93% of the total outpatient amount in Changning District in one year. The bed utilization rate is only 42.48% in the non-public hospitals and meanwhile the bed utilization rate is 82.87% in all the hospitals in Changning District. The medical services offered by the non-public hospitals only account a few of all the medical services offered in Changning District. The education background of the staffs in the non-public hospitals is low and the non-public hospitals lacks staffs with master’ or doctor’ degree. The titles of professional post are unreasonable in the non-public hospitals and the non-public hospitals lacks staffs with the title of a senior professional post. And in the non-public hospitals, the health workers are not stable. Meanwhile, along with the strengthening of the supervision of the non-public hospitals, the number of penalty is increasing gradually from 2009 to 2011. The number of administrative case in 2011 is double from 2009, and it is the same as the bad practice behavior score and administrative penalty.Discussion:1 Non-public hospitals didn’t conduct sufficient investigates before setting which lead to malicious competition among non-public hospitals.2 The investors of non-public hospitals are eager to get profit which lead to the credit crisis.3 Non-public hospitals are lack of health talents and the health workers are not stable.4 There are more illegal practices in non-public hospitals.5 The use of health resources in non-public hospitals is inefficient.6 The supporting policy for non-public hospitals is inadequate and the admittance standards and supervision basis are out of date.Conclusion:1 To position the non-public hospitals accurately in the health system.2 To raise the admittance standards of non-public hospitals and promote its healthy development.3 To bring the non-public hospitals into regional health planning and give them a clear developmental direction.4 To encourage social capital to establish medical institutions.5 To change the ideology and treat the non-public hospitals fairly.6 To speed up the reform of public hospitals’ property right system and explore the co-development mechanism between public and non-public medical institutions.7 To strengthen the brand building and sincerity construction in non-public hospitals and to speed up the construction of the medical personnel team.8 To strengthen governmental supervision and establish perfect warning mechanism and exit mechanism.