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.
At present, balanced scorecard is widely used in hospital performance management, but because of the difficulty in selecting indicators and the ambiguity of causality, its implementation on the application level is limited. Based on the theory of “competitive advantage” and resource arrangement, this study constructs an improved balanced scorecard index system for discipline performance evaluation from the perspective of improving discipline competitiveness of Ningbo No.2 Hospital. The index system mainly includes the dimensions of discipline quality development, resource allocation efficiency and so on, with the characteristics of “focusing on advantages, accurate positioning” and innovation, and has achieved good results in practical application.
ObjectiveTo measure the operational efficiency and explore the phenomenon of the economy of scale in secondary public general hospitals of China for improving the health service efficiency.MethodsFrom February to August 2019, the data set of two input indicators (the number of employees and actual open beds) and two output indicators (the numbers of outpatients and discharges) in 511 secondary general hospitals of Shandong, Anhui, Shanxi, Hubei and Hainan provinces in 2018 were collected for data envelopment analysis. The analysis processes were three folds: First, the technical efficiency, pure technical efficiency, scale efficiency and scale compensation status of the sample hospitals were calculated respectively. Second, the comparative analysis of efficiency value and scale compensation status was carried out in 5 groups according to the bed scale. Finally, the input and output projection analysis was carried out on the ineffective decision making units.ResultsThe medians of technical efficiencies, pure technical efficiencies, and scale efficiencies of the 511 secondary general hospitals were 0.472, 0.531, and 0.909, respectively. In the 511 hospitals, 493 hospitals (96.5%) were in ineffective state, of which 321 hospitals (62.8%) were in the state of decreasing return to scale. The staff redundancy of the group with beds >100 and ≤300 was 23.86%, and its service quantity could be increased by 39.37%.ConclusionsThe overall operating efficiencies are inefficiency in secondary general hospitals of China and the optimal scale of actual open beds is between 300 and 500 beds from the perspective of scale efficiency.
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 status of management and operation in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Method According to the principles and methods of business diagnosis, we designed the questionnaire to investigate the ideas of management and operation among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Result (1) Over 70% participants understood the strategic positioning, brand and development of hospital pharmacy. They had very b senses of innovation and risk awareness, and the comprehensive understanding to the risk and competitive factors. (2) Over 60% considered that the public pharmacies lacked in the awareness of the market competition and crisis, clear management plans as well as the active adaptation to market changes. They were also short of professional dedication and innovation capacity. (3) 52% thought that there was promising future of the public hospital pharmacies. Conclusion The public hospital pharmacies urgently needs the improvement and innovation of the management idea and models.
ObjectiveTo systematically review the effect of implementing the medicines zero mark-up policy in Chinese public hospitals.MethodsCNKI, WanFang Data, VIP, Sinomed, Web of Science, PubMed and EMbase databases were electronically searched to collect quantitative evaluations of the effect of implementing the medicines zero mark-up policy in Chinese public hospitals from inception to October 30th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Descriptive analysis was then performed.ResultsThe existing evidence on the effect of implementing the medicines zero mark-up policy in Chinese public hospitals was from 3 studies based on national samples and 7 provincial level studies in Beijing, Shannxi and Fujian. After the implementation of the medicines zero mark-up policy, all included studies found that the medicines expenditure and the proportion of medicines expenditure to the total expenditure per outpatient visit or per hospitalization decreased. The expenditures of medical supplies, tests & examinations per outpatient visit or per hospitalization increased, and the medical expenditure per outpatient visit or per hospitalization increased in Beijing. The hospital annual revenue generated from medicines and its proportion to the total annual revenue both decreased across the country. Although the government allocated increased subsidy to compensate the revenue reduction of the public hospitals due to the implementation of the medicines zero-mark-up policy, the total annual revenue of traditional Chinese medicine hospitals at the county level across the country still decreased significantly.ConclusionsBased on the available evidence, we conclude that the policy objective of abolishing the mechanism of "compensating medical care with revenue generated from prescribing medicines" is achieved, while that of establishing a scientific compensation mechanism for public hospitals are partially achieved. Compared with other regions, Beijing has appropriately adjusted the prices of medical care while removing the mark-up of medicines, thus is a contributor to the establishment of a scientific compensation mechanism for public hospitals.
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.
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.
This article is based on the work practice of Deyang People’s Hospital in carrying out financial digital transformation under the background of artificial intelligence technology. It clarifies the concepts of financial digitization and artificial intelligence technology, summarizes the practical path of hospital financial digital transformation, and analyzes the specific applications and implementation effects of intelligent filling of expense reimbursement forms, intelligent review of documents, and intelligent management of medical insurance funds. These experiences have positive significance for optimizing financial business processes, improving data quality and utilization efficiency, and enhancing employee satisfaction. They can provide a reference for the digital transformation of financial management in public hospitals and the reconstruction of the value positioning of hospital financial management.
Popularizing health knowledge scientifically and improving people’s health literacy level is one of the most economical and effective measures to improve people’s health level. In carrying out health science popularization work, public hospitals, as the main force of popular science, have some problems, such as lack of enthusiasm of medical staff, unfamiliarity with new means and laws of communication, too professional output and poor popularization effect. In recent years, West China Hospital of Sichuan University has taken the “West China Hospital Popular Medicine Readings” as the popular science brand, and through creating management mode, innovative creation mode, strengthening continuous training and system construction, it has formed a health science brand and explored a set of reproducible long-term mechanism for health science popularization. This article deeply analyzes the problems faced by public hospitals in developing health science popularization work, taking the work mode and achievements of West China Hospital as an example, and explores a new way for other public hospitals, especially small and medium-sized public hospitals, to develop health science popularization work.
