Research On The Financial Compensation Mechanism For Large Medical Equipment In Public Hospitals

Objective:To construct the theoretical framework of financial compensation mechanism for large medical equipment in public hospitals;according to the guidance of the theoretical framework,the paper analyzes the current situation of the configuration and management of large medical equipment in public hospitals,and finds the gap between theory and reality.According to the guidance of the theoretical framework,the strategies of optimizing the financial compensation mechanism of large medical equipment in public hospitals are put forward to provide a real case reference.Methods:(1)This paper uses the literature research method to construct the financial compensation model of large medical equipment in public hospitals,that is,how to allocate and manage the large medical equipment of public hospitals from the perspective of asset life cycle and stakeholder perspective,(2)Using the case study method,the relevant personnel of a district hospital,the health planning committee and the finance bureau of Beijing as the research object,through the guidance of the theoretical framework to collect the primary and secondary information to compile and analyze,describe the reality of the Finance Bureau and How to plan and manage the large medical equipment of the district hospital.Results:(1)The theoretical framework of the financial compensation mechanism for large-scale medical equipment in public hospitals includes five links and three major stakeholders,including five applications,approval,procurement,use and disposal.The three major stakeholders include public hospitals,health administration The competent authorities and the finance department.For the five links,the application link should be submitted by the hospital to the health administrative department of basic information,demand analysis report,feasibility analysis and performance reports and other materials;approval by the health administrative departments of the hospital's service capacity,Equipment utilization and research,and through the third-party professional evaluation of the feasibility of the proposed equipment to be purchased;procurement links by the financial allocation of equipment to purchase money,the health administrative department of the lead organization of the hospital for centralized bidding procurement;use of the hospital needs To establish a sound equipment management system,the establishment of management information system,collecting equipment,daily operation data for performance analysis and evaluation,health administrative departments on a regular basis to monitor the use of equipment;disposal links by the health administrative departments based on equipment life,Performance,performance level and other information processing equipment.Performance evaluation plays an important role in pre-approval and ex-post regulation.In terms of the three major stakeholders,the public hospital as the equipment of the applicant and the user should be based on the actual situation of the district to make reasonable equipment needs,develop a sound equipment management system,collect equipment daily operation data and performance evaluation work.The Health administrative departments as the system providers and fund regulators in the allocation of medical equipment in the process of local regional health planning for a reasonable top-level design and development of supporting policies;the establishment of a sound performance evaluation mechanism for the implementation of large-scale medical equipment Effective supervision.The financial sector as a public welfare protection,should be large medical equipment to provide adequate public finance funds.(2)Case study found that large-scale medical equipment configuration and management process is only the form of a closed-end management,all aspects of the key management risk point failed to effectively avoid.There is a strong fringe incentive for the hospitals in the application of the device,the lack of third-party approval of the third-tier professional institutions,hospital equipment procurement free from the effective regulatory system,the lack of equipment use of the performance level of effective tracking management,Link disposal lack a clear retirement standard;lack of a sound performance evaluation index system.Because the information asymmetry,the hospital has the greatest right to speak;Health and Family Planning Commission on the approval of medical equipment and supervision are in the absence of state;Finance Bureau of the hospital is still insufficient investment,and as a medical equipment investor,the use of funds for the effect Perennial cannot get the appropriate feedback.Optimization of large-scale medical equipment,financial compensation mechanism recommendations:to improve the configuration of large medical equipment before the demonstration system to strengthen the supervision of large-scale medical equipment procurement,the implementation of large-scale medical equipment configuration supervision,a clear stake in the various aspects of the main responsibilities.(3)The results of this case analysis:In the three levels to be proved,9 of the 23 questions,6 questions consistent with the theoretical framework,17 questions and theoretical framework does not match.Non-compliance rate of 73%.Conclusion:In reality,the financial compensation mechanism of large medical equipment in public hospitals in our country is still imperfect and needs to be strengthened in the future practice.To optimize the financial compensation mechanism of large medical equipment:establish a sound performance evaluation index system,strengthen the role of third parties in the examination and approval links,adjust the payment system of procurement links,and strengthen the collection of equipment operation data.