Objective To systematically review the impact of Beijing's comprehensive reform of medical consumption linkage on medical expenses, hospital services, and hospital income. Methods Databases including CNKI, WanFang Data, VIP, CBM, PubMed, and Web of Science were searched to collect empirical research on evaluating the impact of Beijing's comprehensive reform of medical consumption linkage on patient medical expenses and hospital operation (service volume and income structure) from June 15th, 2019 to August 15th, 2021. A descriptive analysis was performed after two reviewers independently screened the literature and extracted data. Results A total of 23 studies were included, and most of them found a relatively small change in the average outpatient and emergency medical expenses after the reform. However, the average inpatient expenses in some hospitals showed an increasing trend; the service volume of most hospitals increased slightly, and the income structure was optimized (e.g., surgery and other medical technology services revenue and its proportion increased). Conclusion The comprehensive reform of the medical consumption linkage in Beijing is the practice of deepening the reform of the medical service price mechanism. Based on the summary of the reform effect, it is recommended to further improve the price mechanism, improve service quality, and promote hierarchical diagnosis and treatment.
Hospital trusteeship means that the property owners of the hospital, through the form of contract and for the purpose of value preservation and proliferation, authorize a corporation or human being with strong administrative management capabilities and risk-bearing abilities to manage the hospital. With the deepening medical reform, the model has been gradually widely used. In this context, a well-known public hospital became the trustee of a newly established comprehensive private hospital. Taking the greatest advantage of its medical quality management, the trustee used SWOT (strengths, weaknesses, opportunities, and threats) analysis to develop efficient decision-making mechanism, strengthened the process optimization transformation, and improved the innovative means of information technology for the development of the new hospital, which has achieved very good results.
Objective To imitate and calculate the ways, input amount and feasibility of governmental compensation to municipal public hospitals in Shenyang city after abolishing drug retail mark-up policy under existing conditions, so as to provide regional demonstration for the decision-making and smooth implementation of public hospital reform. Methods The relevant information of 18 municipal public general hospitals or specialized hospitals during 2008-2010, such as annual basic numeration tables, summary and detailed statements of income and expenditure were collected, and the average data of both national and provincial hospitals in the same or similar level during 2009-2011 were retrieved from China Health Statistics Yearbook. The Questionnaire of Compensation to Medical Institutions was self-designed, distributed and reclaimed in order to get the data of respective hospitals during 2008-2010. Then the following 4 compensation ways were calculated: governmental input compensation, price compensation of medical service, pharmaceutical affairs compensation for price difference, and integrated way of the former 3 compensations; and the feasibility of compensation after health system reform was analyzed. Results a) If the drug retail mark-up policy was abolished in municipal hospitals, the total loss of hospitals would increase from RMB 200 million yuan in 2008 to approximately RMB 330 million yuan in 2010. b) The balance of payments and patient’s cost of Shenyang municipal public hospitals were basically similar to those of both national and provincial hospitals in the same level. c) As for the year of 2010, the new governmental compensation after implementation of new health system reform was at least RMB 438 million yuan, accounted for about 1.8 % of general budget expenditure in Shenyang municipal level. d) The results of the imitation and calculation of 3 price adjustment schemes of medical service showed that, only the third could completely compensate the abolition of drug retail mark-up. e) As to the pharmaceutical service charge based on compensation for pharmaceutical administration, it was RMB 115.6921 million yuan in Shenyang municipal public hospitals in 2010, and it could compensate 58.6% of the drug price difference. f) Compared with the former 3 compensation ways, the integrated compensation way could make public hospitals have general balance of payments which were RMB 115 million yuan, 172 million yuan and 268 million yuan, respectively. Conclusion a) After the abolition of the hospital expense covered by drug revenue, it is reasonable and feasible in increasing governmental compensation according to the annual depreciation cost of permanent assets, adjustment of medical service price, and increase income of pharmaceutical service. b) The second integrated scheme of comprehensive compensation schemes can make most hospitals have some favorable balance; the slightly increasing charge of medical care is affordable by patients and medical insurance departments, so it is operable. c) The successful and sustainable implementation of public hospitals compensation policy depends on the reform of both structure and mode of payment in medical insurance system.
ObjectiveTo compare and analyze the expenses of inpatients before and after the implementation of the adjustment plan for " abolition of the addition of drug expenses” (also called zero-addition of drug costs) in Sichuan Province, in order to provide a certain reference for understanding the effect of this reform policy and further optimizing the formulation.MethodsFrom the hospital information management system, the data of inpatients with gastric cancer in a tertiary general hospital in Sichuan Province from January to September 2016 (before implementation) and from January to September 2017 (after implementation) were collected and compared. The change in hospitalization expenses of relevant patients before and after the implementation of the adjustment plan for canceling the addition of drug expenses was analyzed.ResultsA total of 2 878 patients were included in the survey; from January to September 2016,1 453 patients were included, and from January to September 2017, 1 425 patients were included. Before and after the implementation of the policy, the median hospitalization expenses of patients with gastric cancer decreased from 7 331.31 yuan to 7 145.12 yuan, with a decrease of 2.54%; the median expenses of medicines decreased from 4 839.79yuan to 4 246.10 yuan, with an decrease of 12.27%; the median expenses of check and inspections increased from 740.00 yuan to 859.00 yuan, with an increase of 16.08%; the median expenses of treatment increased from 251.00 yuan to 424.00 yuan, with an increase of 68.92%; compared with the total expenses and drug expenses before implementation, the total expenses and drug expenses after implementation decreased significantly, while material expenses, treatment expenses, check and inspection expenses and other expenses increased somewhat (P<0.05); differences in radiotherapy expenses and surgical treatment expenses before and after the implementation of the policy were not statistically significant (P>0.05).ConclusionsAfter the implementation of the policy of " abolition of drug expenses addiction”, the total expenses is slightly reduced for the expenses composition of patients with gastric cancer. Through the strengthening of the internal operation and management of the hospital, the government should continually optimize the public medical institution. At the same time, the government should put the compensation mechanism in place and continuously improve the payment method of medical insurance to ensure that the medical value of medical personnel is respected and the medical needs of ordinary people are guaranteed.
A new human resource management system in West China Hospital of Sichuan University has been constructed to inspire work enthusiasm and innovation of the front-line medical staffs, strengthen the cohesion of the hospital, better service for patients, and promote high-quality development of the hospital. This paper introduced it and provided references for related researches.
ObjectiveTo discuss the ways and effects of carrying out the publicity and education of Party style and clean governance in public hospitals through enterprise WeChat, aiming at improving the quality and efficiency of the publicity and education and forming an accurate and real-time pattern of discipline warning education.MethodsTaking the articles regarding the publicity and education of Party style and clean governance on the enterprise WeChat of West China Hospital of Sichuan University as the research object, the content analysis method was used to review the content from October 2017 to December 2018 and its publicity effect. The number of readers was shown in median (lower quartile, upper quartile) and the statistical analysis was done through rank sum test.ResultsFrom the content updated, medical staff read more about Internet hot spots and related clean governance news happened around them [M (QL, QU): 1 106 (691, 1 506)] than policy learning [301 (233, 408)] (P<0.05) and knowledge explanation [392 (457, 1 133)] (P<0.05). In terms of the methods of the update, medical staff read more about the update in traditional text and pictures [462 (312, 1 073)] than cartoon, video and other methods [230 (175, 315)] (P<0.05).ConclusionPaying attention to updated content, increasing the discussion function of the audience, choosing the time that the audience likes to update the article, and in the meantime, building the brand for the publicity and education of Party style and clean governance in the hospital may have a better effect on the education of Party style and clean governance toward Party members and medical staff in public hospitals.
High-quality development has become the command stick for the current reform of medical institutions. This article combines the practical experience of West China Hospital of Sichuan University to sort out the difficulties in the construction of provincial medical quality control centers in China. It summarizes the problems in policy support, intervention methods, work content, network construction, discipline construction, and quality control efficiency of provincial medical quality control centers, and proposes that building a collaborative platform based on key management projects, establishing a multi-level operation mode, and constructing a benchmark construction model are the key paths to reform the management of provincial medical quality control centers.
According to a guideline on promoting the high-quality development of public hospitals issued by the General Office of the State Council and a guideline on accelerating the development of medical rehabilitation, a high-quality and efficient rehabilitation system should be established, and efforts should be made to promote the high-quality development of rehabilitation services in public hospitals. We propose an action guideline for promoting the high-quality development of rehabilitation services in public hospitals, which is based on a Delphi method questionnaire on the opinions of front-line clinical rehabilitation experts, and integrated with relevant literature and evidences. This guideline introduces 31 specific action plans from 7 dimensions, including standardization of basic rehabilitation settings, standardization of clinical rehabilitation techniques, improvement of the tertiary rehabilitation system, standardization of emergency rehabilitation, standardization of rehabilitation education, standardization of rehabilitation management, and promotion of scientific and technological innovation in rehabilitation medicine.
Objective To investigate the current leadership status of public hospital pharmacies, and to provide evidence and suggestions for further improving the performance of public hospital pharmacies. Methods According to our conception of the key characteristics of leadership, we designed a questionnaire to investigate leadership practices among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% of participants thought that public pharmacies lacked independent decisiveness; power was distributed; and elections were democratic. (2) Nearly 60% thought that public pharmacies lacked effective communication and awareness of service. (3) Nearly 70% thought that leader’s abilities were not exceptional. (4)There were not obvious advantages or disadvantages among the leaders. (5) Half trusted the leaders and thought there should be no change. Conclusion Public hospitals should grant more power to pharmacies to implement effective leadership.
ObjectiveTo measure the total factor productivity and its component changes of public secondary general hospitals in China from 2012 to 2018.MethodsFrom February to September in 2019, stratified systematic sampling method was used to collect the panel data of input and output indicators from 2012 to 2018 of 511 public secondary general hospitals in 5 provinces of China (Shandong, Hubei, Hainan, Anhui, and Shanxi), and Bootstrap-Malmquist-data envelopment analysis was used to calculate the total factor productivity and its component changes of the hospitals.ResultsFrom 2012 to 2018, the total factor productivity of the 511 public secondary general hospitals decreased by 0.22%, technical efficiency decreased by 5.24%, technical changes increased by 5.29%, pure technical efficiency decreased by 1.40%, and scale efficiency decreased by 3.89%, respectively.ConclusionsIn the past 7 years, the total factor productivity of public secondary general hospitals in China has declined slightly, mainly due to the decline of scale efficiency and pure technical efficiency, and the technological progress is the main reason for its improvement. The implications for the public secondary general hospitals are three folds: avoiding blind expansion and exploring optimum scale of beds, strengthening the internal fine management to improve the management practice and technical efficiency, and promoting technological progress by healthcare cooperating organizations.