Research On Interest-Related Parties Of Public Hospital And Their Demands Based On Establishing Modern Hospital Management System

Objectives One of the key tasks of the deep medical and health system reform is about the public hospitals.It is imperative to establish a modern hospital management system and promote comprehensive reform of public hospitals.And it's also significant to recognize the interest-related parties of public hospital reforms,clarify the relationship between all parties and analyze their influence on the reforms.Those could speed up the development of public hospital internal system under the background of modern hospital management system and ensure the effect from the comprehensive reforms of public hospitals.In this research it's discussedtwo aspects: one is the definition of the interest-related parties ofpublic hospital based on establishing modern hospital management system,and the other is their demands.Methods This research used literature research methods,questionnaire methods,data statistics and analysis to investigate experts and scholars with rich experience in hospital management such as the administrative departments,public hospital administrators through Delphi Method and Mitchell Score-based Approach.It's used Delphi Method and Likert scale to investigate the public health administrative institutions,medical insurance institutions,public hospital staff and patient which was closely related to the interest-related parties of public hospital and carried out its specific interest demands.This research used Epidata 3.1 to input questionnaire data and SPSS 20.0 to analysis.Results 1.Through two rounds of experts' consultation and investigation,23 interest groups were defined as interest-related parties of public hospital,including healthcare committee,medical insurance office,financial management department,development and reform committee,public hospital staff,Price-Fixing Bureau,patients,public security law department,human resource management department,disease prevention and control center,community health service center,food and drug administration,media,blood station,social public,science and technology innovation committee,pharmaceutical equipment consumables suppliers,medical colleges,medical associations,logistics service companies,social hospitals,banks,commercial medical insurance companies.2.In the present research,public hospital stakeholders identified by the mentioned experts are divided into three categories:Type A-The Definitive(health administrative agencies,medical security bureau,financial departments),Type B-The Expected(Development and Reform Commission,hospital medical staff,price departments,patients,public security and law departments,human resources departments,disease prevention and control departments,community health service centers,food and drug administrations,media,blood stations,the public,science and technology management departments,medicine suppliers),Type C-The Potential(consumables suppliers of medical equipment,medical education institutions,medical industry associations(organizations),companies for socialization of rear service,private hospitals,banks,profitable commercial medical insurance institutions).3.18 specific interest claims of the Health Council include: formulating hospital regulations,establishing an evaluation mechanism,improving the medical quality and safety management system,improving the personnel training system,developing convenient services for the people,participating in the development of medical complexes,realizing employing autonomy,strengthening Party organization construction and work of Party development,improving democratic management system and performance appraisal system,enhancing accounting and auditing supervision system,improving human resource management system,financial asset management system,and information management system,strengthening hospital culture construction,improving social supervision and self-discipline of the industry as well as scientific research management system,and the logistics management system.The attention degree of health administrative departments towards the above interest demands decreases progressively.4.15 specific interests of medical insurance institutions towards public hospitals include: strict implementation of national charging standards,reasonable selection of inspection items and treatment methods,adequate supply of medicines,standardized transfer and referral,improving medical insurance rules and regulations,firstly choosing medicines of Class A in the national drug reimbursement list,improving the medical insurance information system,accepting supervision and inspection from the medical insurance departments,properly handling complaints of patients,rationally using medicines not in the national drug reimbursement list,publicizing medical insurance policies,enhancing medical insurance management organizations, preventing fraudulent use of medical insurance funds,and strictly implementing standards for hospital admission and leaving the hospital,providing training of medical insurance policies for employees.The attention degree of medical insurance institutions towards the above interest demands decreases progressively.5.The interest demands of medical staff working in public hospitals towards public hospitals include: work safety,reasonable wages and better benefits,adequate medical staff,performance appraisal system,career promotion system and space,continuing education opportunities,clinic environment and office equipment,measures to ease work stress of employees,employment mechanism,pride of medical staff,hospital affairs disclosure system,the social influence and reputation of the hospitals,employee congress system,channels for reflecting demands of medical staff,support for doctors to work in various places.The attention degree of medical staff working in public hospitals towards the above interest demands decreases progressively.Male medical staff pay more attention to the hospitals' reputation,performance distribution and personal career development space.Female medical staff pay more attention to the hospitals' working environment,expression of demands and system development.6.The interest demands of patients towards public hospitals include: professional knowledge and high medical level,medical ethics,standardized medical services,secrecy of patient privacy and illness,patients' right to know,medical equipment,equal treatment to patients,compliance with charging policies,adequate medical personnel,scientific,reasonable and convenient medical treatment process,social influence and reputation,reasonable selection of inspection items and treatment methods,providing services required by patients,stable hospital information system,providing daily fee list and fee inquiry service,convenient service facilities,good medical treatment environment,revealing information of medical service charges and standards,free choice of medical staff,providing multiple complaint channels for medical service,creating an convenient environment for family members and friends to take care of and visit patients,providing dietary guidance,nutritious and delicious meals.The attention degree of patients towards the above interest demands decreases progressively.Female patients generally pay more attention to following factors than male patients: stable hospital information systems,dietary guidance,nutritious and delicious meals,revealing information of medical service charges and standards at conspicuous and accessible places,free choice of medical staff,etc.Conclusions 1.Public hospital should adapt to the new situation,break the profit-seeking mechanism and adopt a management strategy demonstrating public welfare on the basis of new requirements.When conflicts were among interest-related parties,public hospital should make correct choices between their different requirements that make comprehensive reforms in public hospital being effective.In this study about the different interest-related parties,public hospital should put the interests of patients in the first place and pay more attention to it,and try to satisfy it.2.From the results of this study,under the background of the modern hospital management system,public health administrative institutions,urban health insurance institutions,urban residents medical insurance institutions are all classified to the definitive.Public health administrative institutions willpay more attention to the tasks of establishing a modern hospital management system,and actively promote the establishment and improvement of modern hospital management systems.Under the new situation,the influence of medical insurance institutions on the operation and management of public hospitals is growing.Therefore,public hospital should takethe comprehensive and fulfilled management strategy and pay more attention to meet the interests of medical insurance institutions.Public hospital must strictly carry relevant regulations and standards,and strengthen the management of medical standards.3.From the results of this study,medical staff are classified to the expected of public hospitals,and they play an important role in the comprehensive reform of public hospital.Therefore,public hospitals should actively meet the interests of medical staff,provide them with a safe working environment,reasonable wages and benefits,and adequate medical staff.For different types of them,it is necessary to carry targeted management measures to satisfy their interests.4.In order to speed up the establishment and improvement of the modern hospital management system,the public health administrative institutions and public hospitals should take the initiative to pay attention to and follow their interests,innovate the internal management system of public hospital,continue to improve the medical service,meet the medical service needs of interest-related parties,fully motivate the initiative of medical staff,establish a harmonious relationship between doctors and patients,unify social benefits and operational efficiency,realize modernization of hospital governance system and management.Finally,it's in order to promote Healthy China and lay a solid foundation.