Research On The Performance Of County Level Public Hospitals In Hubei Province

Objective:To understand the Hubei province county public hospital comprehensive reform,the implementation of the policy,the county public hospital medical service operation is the impact of the medical income structure optimization,financial and economic operation is smooth,whether to alleviate the burden of patients,study the operating circumstances of public hospitals at the county level,to find the problems of the reform,puts forward suggestions countermeasures for related decision-making departments,has the practical significance.Methods:The county level public hospitals in 64 counties and cities in Hubei province were selected as the research object,and the local people's hospital or the first hospital was selected as the sample.Data sources from the Hubei provincial health and Family Planning Commission on the basic operation of the county public hospital survey and the province's health and family planning financial statements,the time span from 2012 to 2015.Using SPSS software to measure the data using the average and the total,count data using percentage analysis.On the division of county general public hospitals for three pilot batches,respectively statistics overall and each batch of pilot hospital service ability,income and assets operation,the burden of patients,and compare analysis.Results:(1)From 2012 to 2015,the average annual growth rate of Hubei province 64 County comprehensive public hospital outpatient and emergency number is 7.79%,the number of discharge with an annual growth rate of 10.12%per cent growth;emergency inpatients from 8.80 in 2012 to 9.39 in 2015;the average hospitalization days of patients discharged from hospital from 2012 8.61 to 2015 8.41 days;occupancy rate decreased from 111%in 2012 to 99.75%in 2015.(2)The total income and total expenditure of 64 county level public hospitals in Hubei province showed an increasing trend,the average annual income growth rate of the past four years was 15.78%,the average annual growth rate of total expenditure was about 18.13%.Balance of payments rate continued to decline,down from 11.76%in 2012 to $6.25%in 2015.(3)The proportion of financial subsidy income is generally between 3%-5%,the average annual growth rate of drug income is 10.58%,and the proportion of the total amount decreased from 2012 to 35.21%in the year of 2015 to 30.69%.The average annual outpatient income growth rate of 12.97%,with an average annual growth rate faster before three followed by surgical treatment such as income,laboratory fees,inspection fees;hospital income average annual growth rate of 17.10%,with an average annual growth rate faster before three are laboratory fees,examination fees,surgical treatment beds and other income.(4)The average annual growth rate of the total assets of 64 county-level public hospitals in Hubei is about 18.91%,and the average annual growth rate of total liabilities is about 23.75%.The annual growth rate of total liabilities was higher than the growth rate of total assets,asset liability ratio increased from 43.13%in 2012 to an increase of 48.61%.(5)Hubei 64 county-level public hospitals in the emergency department of the average cost increased from $168.48 to $146.35 in 2015,the average cost of medical expenses increased from $4462.90 to $5302.67 in 2015.The first batch of pilot hospitals with the highest average cost of medicine,the second batch of pilot hospitals followed,the minimum number of pilot hospitals in the third.Conclusions:(1)Different batches of pilot public hospitals in the county total revenue and total expenditure is increased,the total growth rate has been higher than the total revenue growth,the balance rate to reduce the phenomenon exists in the hospital balance on.(2)This study also found that different batches of the total balance of payments in the hospital declined in the year and the batch of public hospitals in the year of reform is more consistent,may be related to the cancellation of drug plus income.(3)The government's inadequate investment in financial subsidies to the hospital,is a common problem in the reform of public hospitals around the country,while the financial investment is not the same.(4)Drug zero rate of implementation of outpatient and inpatient income accounted for the proportion of drug revenue has declined,but the increase in the proportion of inspection income,laboratory income,suggesting that the drug income to make up for the existence of a flat transfer.(5)The growth rate of total liabilities is higher than the growth rate of total assets,asset liability ratio is a common phenomenon of public hospitals at the county level,Hubei County comprehensive hospital assets and liabilities ratio of more than 40%of the cordon.