Analysis On The Operation And Efficiency Of Comprehensive Public Hospitals In Jiangsu Before And After The Reform

From the beginning of 2015,Jiangsu carried out the reform of public hospitals in the city within the province,for this reform,this paper through comparative analysis of the city comprehensive public hospitals are in operation condition and operation efficiency before and after medical reform,in order to evaluate the effect of the reform,the existing problems,so as to improve the efficiency of the hospital and continue to put forward suggestions to promote reform.Objective:Through the comparative analysis of the running status and operation efficiency of the sample hospitals before and after the reform,we can evaluate the effect of the medical reform,and provide suggestions for improving the operation efficiency and improving the medical reform measures.Methods: Participants: a total of 80 public health hospitals in Jiangsu province participated in the medical reform.A questionnaire survey was conducted among the80 hospitals.After screening the questionnaire,a total of 62 hospitals met the requirements.The public hospitals in these 62 cities are taken as samples.Methods:descriptive analysis and data envelopment analysis(DEA).Based on the basic situation of the sample hospital for 2014-2016 years by Excel and spss22.0 analysis,and then to 2014-2016 in sample hospitals were analyzed by CCR,the annual efficiency of cross-sectional BCC model,combined with the Malmquist index model for dynamic analysis of longitudinal.Results:(1)Medical resources: after the implementation of the reform,the number of workers,the number of licensed physicians,the number of registered nurses,the fixed assets and the total liabilities of the hospital have all achieved growth.(2)Service provision: after the implementation of the reform,the number of outpatient and emergency persons,the average cost of diagnosis and treatment and the average hospitalization expenses decreased,and the number of discharged patients and the average hospitalization days increased.(3)The basic situation of income and expenditure: after the implementation of the reform of hospital income,business income,total income,outpatient outpatient medical service income,total hospitalization income,hospitalization service income and expenditures increased compared to before the reform,outpatient drug income and hospital drug income than before the reform to reduce.(4)The results of CCR model analysis have no significant difference between the comprehensive technical efficiency and the comprehensive technical efficiency of the hospital before and after the medical reform.(5)The BCC model analysis of pure technical efficiency and pure technical results before and after the hospital reform has no significant difference between the efficiency,scale efficiency and scale efficiency of the difference was not statisticallysignificant,increasing returns to scale the number of hospitals had no significant difference,diminishing returns to scale number difference was statistically significant,the number after the reform of diminishing returns to scale significantly reduced hospital.(6)The result of the Malmquist index model analysis is the decline in total factor productivity of the hospital before and after the reform,due to the decline of technology.Conclusions:(1)The implementation of drug zero margin effect is obvious,through the implementation of drug zero sales,reduce the cost of drug purchase,and reduce the hospital's dependence on drug income.(2)Patients' burden of seeing a doctor is reduced.The reduction of drug price reduces the expenditure of patients in medicine to some extent.The price of comprehensive examination is reduced and the overall burden of patients is reduced.(3)The gap between revenue and expenditure increased,and there were hidden dangers in the operation of the hospital.(4)The overall operation efficiency of the hospital declined.Recommendations:(1)To build a streamlined and efficient drug purchase system.(2)Encourage hospital medical technology innovation,optimize the process and improve the level of information(3)Rationally guide the diversion of patients,release the limitation of doctor's practice and synchronously restrict the expansion of public hospitals.