A Case Study On The Effectiveness Of Trusteeship Reform In Certain Traditional Chinese Medicine Hospital Of Shanxi Province

BackgroundIn our country,public hospital is the main body ofmedical and health service system.In order to the macroscopic development of health system,efficient operation and health outcomes,the country began to explore the reforms of public hospitals,build the medical association,take the hierarchical diagnosis and treatment,improve the efficiency of the hospital.trusteeship reform is one of the public hospital management system reforms,it is significant to research the management system,operation system and the operation efficiency.ObjectivesThis study based on the analysis of the development of hospital to analyze the change of the management system after the Trusteeship reform.analyze the medical services and the economic benefits before and after the Trusteeship reform,analyze the satisfaction between the hospital workers and patients,then set up the index system for the comprehensive evaluation,provide suggestions for the reform of public hospital and government.MethodsThe Literature review and descriptive statistics method was used to analyze the changes of management system after the Trusteeship reform.The before and after comparison method was used to analyze the medical services and the economic benefits.Factor analysis method was used to analyze the satisfaction between the hospital workers and patients.The delphi method was used to set up the index system,then the efficacy coefficient method was used to make the comprehensive evaluation.Results1.Management system: After the Trusteeship reform,ownership and management rights have been separated,hospital management according to the Corporate Governance.Set up seven professional committee for the different management work.After the Trusteeship reform,hospital use the independent accounting and selfsustaining.Hospital set up “green channel” to take the hierarchical diagnosis and treatment.2.Medical services: As the base of 2012(before the Trusteeship reform),Compared with2012,The number of inpatients,emergent patients,bed utilization ratio,turnover rates of hospital beds have increased.2013,2014 and 2015 Compared with2012,the number of inpatients have increased by30.29%,60.46% and72.23%.turnover rates of hospital beds have increased 4.81,3.54and7.09.3.Economic benefits:As the base of 2012(before the Trusteeship reform),after the Trusteeship reform,medical income,medical care expenditure,Patients with all costs have been increased.Compared with 2012,medical income in2013,2014,2015 increased by10.40%,118.06% and 150.70%.Medical care expenditure in 2013,2014,2015 increased by 56.15%,111.63%,138.22%.4.Satisfaction: Before and after the trusteeship reform,the score of the satisfaction between workers is 4.26 and 4.52.The score of the satisfaction between outpatients is 4.41 and 4.35.The score of the satisfaction between inpatients is 4.23 and 4.73.After the trusteeship,the satisfaction of workers and inpatients are better than before the reform,but the satisfaction of outpatients is lower than before the reform.5.Comprehensive evaluation: Through the efficacy coefficient method,the score of the efficacy coefficient is 0.6406 in 2012,the score of the efficacy coefficient is 0.7735 in 2013,the score of the efficacy coefficient is 0.8665 in 2014 and the score of the efficacy coefficient is 0.9625.The score of the efficacy coefficient is better year by year from 2012-2015.Recommendations1.The Government should carry out the relevant policy reform about Health policy,the legitimacy of the practice across the province.2.Strengthening diagnosis of the core competitive power of the hospital,build the brand of trusteeship.3.Specifying the position of the trusteeship reform of public hospital from the medical service and economic benefit.4.The worker and patient's feelings should be paid enough attention when the trusteeshipreform arecarried out.