| Objective By investigating the health manpower status of 34county-level MCH hospitals(maternal and child care hospitals)in the third batch of county public hospital reform in Guangxi,this study analyzed the health manpower status and hospital medical service quantity after the comprehensive reform.Hospital income and expenditure,hospital medical expenses,hospital operating efficiency,and changes in service quality,liabilities,doctor-patient satisfaction and the results achieved.This paper evaluates the effect of comprehensive reform of the third group of county-level public hospitals in Guangxi,summarizes the experience,finds out the problems,and puts forward the countermeasures and suggestions for the next work.Through investigation,the comprehensive reform effect of 34 county-level MCH hospitals involved in the third batch of county public hospitals in Guangxi was evaluated and analyzed,the experience gained from the pilot project was summed up,the existing problems were found,andcorresponding countermeasures and suggestions were put forward.Methods 1.Thirty-four county-level MCH hospitals that participated in the comprehensive reform of the third batch of county-level public hospitals,mainly included the social and economic development of the county and the basic situation of health resources and health services(social and economic development,government health investment,etc.)State of health resources and health services at county level,basic medical insurance system at county level,evaluation of current situation of MCH hospitals at county level(hospital capital construction status;hospital health manpower situation;hospital medical service volume;hospital income and expenditure and its composition;Hospital liabilities;hospital medical expenses,etc.).2.Five counties were selected as samples to investigate the work intensity,personal income level and expectation,job satisfaction and so on.3.To extract the samples county maternity and child care outpatient and inpatient,questionnaire survey,the county maternity and child care outpatient and inpatient medical hospital,for the evaluation of hospital environment,for the evaluation of medical treatment process and provide services.Results.The basic situation of the reform: the number of women and children's health care centers at the county level in Guangxi increased from 4089 in 2014 to 4697 in 2016,an increase of 14.87.The number of beds set up in 2016 reached 2147,up 1968,or 9.10 percent,from 2014.Revenue rose 51.35 yuan from 153.3729189 billion yuan in 2014 to232.1372869 billion yuan in 2016,while financial subsidies rose 104.83 yuan to 100.9353265 billion yuan in 2016 from 49.2781873 billion yuan in 2014.After the reform,the technical level and health resources ofcounty maternal and child health care hospital in Guangxi have been improved better,the balance of income and expenditure has been balance,and the county maternal and child health care hospital has been developing steadily and continuously.1.Reform of servicesThe total number of patients in 34 county MCH hospitals in Guangxi increased from 2372413 in 2014 to 2942496 in 2016,an increase of24.03.2016 to 2720663,up 21.48 from 2720663 in 2014.The number of hospitalizations was 151077 in 2016,Compared with 132905 in 2014,the number increased by 13.67%.After the reform,the service capacity of 34county-level MCH hospitals in Guagxi was improved,the utilization efficiency of medical services was improved,and the accessibility and fairness of health services were improved.2.Changes in assets and liabilitiesAfter the comprehensive reform of county-level public hospitals,the total assets of 34 county-level MCH hospitals in Guangxi were 1.151 billion yuan in 2016,up from 888 million yuan in 2014,with an average annual increase of 14.81 yuan.Total liabilities rose from 157 million yuan in 2014 to 325 million yuan in 2016,an annual increase of 53.50 yuan.The asset-liability ratio rose from 17.72% in 2014 to 28.20% in 2016.3.Satisfaction of medical staff and patients with hospitalsCounty Maternal and Child Health Hospital medical staff job satisfaction 22.86.The comprehensive satisfaction degree of outpatients was 70.94,and the proportion of patients dissatisfied with outpatient service was 14.27.The comprehensive satisfaction degree of the hospitalized patients was 85.32,and the proportion of the patientsdissatisfied with the inpatient service was 3.67.The medical staff of county MCH hospital are eager to improve the income level,working environment and working conditions,and raise the level of welfare treatment.The masses are eager to lighten the burden of seeking medical treatment.Conclusion 1.The infrastructure construction,human resources and service volume of 34 county-level MCH hospitals in the third batch of comprehensive reform of public hospitals in Guangxi have been effectively upgraded,and the quality and efficiency of hospital services have been effectively improved.Basically meet the health needs of women and children in the county,from this point of view,the comprehensive reform has remarkable effect,to achieve the desired goal of the reform.2.The income and expenditure of 34 county-level MCH hospitals in the third batch of comprehensive reform of public hospitals in Guangxi showed an increasing trend.Since the lack of the third batch of reform pilot projects,the average outpatient expenses of the pilot hospitals have not decreased in general compared with those before the reform,whereas,on the contrary,There has also been a certain rise,but overall,the problem of unreasonable growth in medical costs still exists.3.The scale of assets and liabilities of 34 county-level MCH hospitals in the third batch of comprehensive reform of public hospitals in Guangxi showed a trend of expansion,the level of liabilities increased obviously,and they faced financial risks.4.The level of job satisfaction of medical staff in MCH hospitals at county level is low.The medical staff in hospitals are eager to improve their income level,working environment and working conditions.It is necessary to establish an effective incentivemechanism and to perfect the distribution system and the performance appraisal system.Improve the level of welfare benefits and work enthusiasm.5.The overall satisfaction of outpatients and inpatients in MCH hospitals at county level was low,which was mainly due to the increase in the burden of medical treatment for the masses due to the high cost of medicine.Hospitals should improve service environment,strengthen supervision of medical service quality,establish and improve patient appointment system,optimize service flow,transparently charge standard,combine medical insurance system,and explore more reasonable payment mechanism.In order to improve patient satisfaction. |
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