Research On The Implementation Effect Of Xinjiang Tertiary Hospital Trusteeship And Assistance To County-Level Hospitals In Southern Xinjiang

Objective: To explore the practice,effectiveness and existing problems of comprehensive trusteeship and assistance to county hospitals in southern Xinjiang;Comprehensive evaluation of the comprehensive operation of the hospital before and after the trusteeship and assistance;Summarize the experience of condensed trusteeship and assistance,and provide reference for improving the health service quality and service capacity of county-level hospitals in remote areas;To provide basis and reference for health authorities and hospitals to formulate corresponding assistance measures.Methods:Questionnaire survey and interview were used to investigate the basic situation of the county where the sample hospital is located,the problems faced by the sample hospital,the implementation of the comprehensive trusteeship and assistance policy and the comprehensive operation after implementation;Using the method of descriptive statistical analysis,the data of the sample hospitals from 2017 to 2021,such as the basic diagnosis and treatment service volume,medical service efficiency,medical service capacity,medical expenses,economic benefits,were statistically described,and the changes before and after the aid were compared and analyzed;The comprehensive evaluation indicators of this study are determined through literature review and expert consultation and demonstration;The entropy weight TOPSIS method,RSR method and their fuzzy joint evaluation method are used to conduct a comprehensive evaluation of the implementation and operation of the trusteeship and assistance work,and the Kendall coefficient consistency test is carried out on the comprehensive evaluation results.Results: 1)The various business indicators of the sample hospitals have changed significantly after receiving aid.The number of basic diagnosis and treatment services such as annual outpatient,emergency and discharge has increased sharply,and the existing business volume has increased by three times in 2019;With the surge of various business volumes,the number of hospital beds has been increased,the average hospital stay has been shortened,and the service efficiency has been effectively improved;With the increase of patients and difficult cases,the rate of grade Ⅲ and Ⅳ operations,new projects and new technology cases have increased significantly;2)This study has determined the evaluation index system for the comprehensive operation of trusteeship and assistance of county-level hospitals in Xinjiang tertiary hospitals,including 6 first-level indicators and 21 second-level indicators.The research has proved that the system has good content validity and credibility,and its Cronbach’s Alpha value is 0.914;3)The comprehensive evaluation results show that the increase of Ci value and RSR value after the aid is significantly higher than that before the aid.The comprehensive operation in 2021 is the best,with the rank average of 1.333,followed by 2019 and 2020,with the rank average of 2.133 and 2.533,respectively.The rank average of 2018 and 2017 is relatively close,with the rank average of 4.467 and 4.533,that is,2021>2019>2020>2018>2017.The consistency test results of the evaluation results show that,The results of each evaluation method are almost identical,with Kendall’s W=0.825.Conclusion: Through the implementation of the comprehensive trusteeship and assistance policy,the sinking of high-quality management team,experts and technology has attracted the local people to come to see a doctor.The basic diagnosis and treatment services of the people’s hospitals in the recipient counties in the southern Xinjiang region have increased significantly.The local people of all ethnic groups have enjoyed more convenient,more standardized and better medical services.The problem of "difficult and expensive to see a doctor" has been effectively solved,It has achieved the homogenization of the medical community and the diagnosis and treatment norms,and also improved the reputation and influence of the help hospital,highlighting its social responsibility and public welfare value.