| Objective:Analysis of the income,operating conditions and the influence of hospital operation efficiency in the county public hospital in Sanming after the reform of “zero makeup" drugs,explore the problems of county level public hospital compensation mechanism and put forward the corresponding policy recommendations.Method:The data in the study root in field investigation and Straight to national health information network system.According to the relevant data from the reform of public hospitals at the county level in Sanming in 2009-2014,Appling the method of combining quantitative analysis and qualitative analysis,Using descriptive statistical method to calculate and analyze the change of various income compensation in the public hospitals at the county level in Sanming before and after the reformation of “zero makeup " drugs,and compared with the unreformed hospital. By deap2.1 and EMS1.3,Data envelopment method was used to evaluate the relative efficiency,super efficiency and efficiency changes before and after reform of hospital,And through stata12,using Tobit regression to further explore the factors affecting the efficiency of the hospital.Furthermore, by the questionnaire survey to understand patient's perception of the reformation of “zero makeup" drugs and the satisfaction of medical staff for “zero makeup”drugs reform, by the interview method to understand the views and opinions of reformation from hospital managers.Result:1.Results of the data analysis show that the income structure of 17 hospitals in Sanming appears big changes before and after the reformation, the proportion of fiscal subsidy accounted for the total revenue increased by 5% or so,the other special subsidies from the government at the county level are different,it due to the differences of each county financial resources.The drugs income accounts of the medicine gross income drop by about 20%,the service price which can reflect the value of medical staff labor increased, however,adjustment of the price of medical service has a more favorable to the general hospital which has more surgeries, for the hospital of traditional Chinese medicine which the quantity is given priority to with medicine, it is difficult to compensate for the revenue loss of “zero makeup” drugs.2.From the perspective of the contrast of hospital reformed and unreformed,the drug proportionin of reformed hospital is far lower than the unreformed hospital,the fiscal subsidies income of reformed hospital is higher than the unreformed hospital,and the income structure is more reasonable than the unreformed hospital.3.The total factor productivity of 17 hospitals in Sanming is improved.From the results of hospital efficiency analysis,the difference of comprehensive efficiency(P=0.064)and technical efficiency(P=0.663),was not statistically significant between the reformed hospital and unreformed hospital,however,the difference of Scale efficiency is statistically significant(P=0.016).4.The analysis of Tobit regression revealed,the efficiency value is positive correlated with the medical income(excluding pharmaceuticals), the ratio of the number of outpatient visits and hospitalization,whether it is the hospital of traditional Chinese medicine,the business income per person in phys-icians,and turnover rates of hospital beds. And the efficiency value is negative-ly correlated with every bed financial aid,drug proportion,hospitalization time cost,fixed assets and staff spending. And there is larger correlation between the efficiency and medicine proportion.5. From the result of questionnaire survey, the satisfaction and the awareness to “zero makeup" drugs of patients in sample hospital is higher,on the satisfaction of medical treatment charge, there are 82.8% patients feel satisfied.Furthermore, there are 56.9% medical staff in sample hospital are satisfied with “zero makeup" drugs,there are 85.4% medical staff think should add pharmaceutical affairs service charge,and the difference of satisfaction to “zero makeup" drugs between different position is statistically significant.(?2=11.307,P=0.001).And medical and pharmaceutical personnel satisfaction was lower than those of other jobs.Conclusion:This paper compare public hospitals at the county level in Sanming which fully implemented the reformation of “zero makeup " drugs with the public hospitals at the county level has not yet implemented the reformation of “zero makeup" drugs by the end of 2014,to explore the compensation and efficiency of reformed hospitals and unreformed hospitals,to analy the achievements and shortcomings of reformed hospitals and the differences between the reformed hospitals and unreformed hospitals.Analysis obtained :First, the drugs income accounts of the medicine gross income sharply decreased,government financial investment increased,and there was a wider range of medical services price adjustment..Before and after the reform,the income and expenses of hospitals is balanced. Second,the overall efficiency of hospitals after the reform was improved.Third,the satisfaction to the reformation of “zero makeup " drugs of medical staffs and patients is higher. Shortcomings: First, the reformation of “zero makeup" drugs has not reduced the costs of patients.Second, the government investment did not get very good play.Third, the distinction degree of medical service price adjustment is deficiency, and the labor value of pharmaceutical affairs was not considered. |
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