| Objectives: In order to learn about actual conditions and resource utilization of enterprise hospitals in Shi jiazhuang. That models, methods, difficulties and related policies about public enterprise hospital's separation is to be discussed. Aim to matching public enterprise's reform, to making references for policy-make departments.Materials and methods: Self-made questionaires were mailed out to enterprises related hospitals in Shi jiazhuang. It contains: class of hospitals, human resources, basic facilities, service work, incomes and outcomes, types of medical system, hospital and its enterprise's atitiudes to separation, reasons of disagreement, content ways of seperation etc. At the same time, 10 county class hospitals in same level were studied for a comparison. The focus had been put on tens of bigger enterprise hospitals. Professional people were sent to hospital leaders to find out details such as, difficulties of hospital at present, their opinions to seperation, what were key points and difficulties of seperation. The datas were input and sorted in Excel, analyzed use SPSS 11.5 for windows. Descriptive statistics use relative numbers and obsolutive numbers. Comparison of proportion and correlation analysis was evaluated by Chi-square test. Results: By the end of 2002, there were 4160 works altogether in 40 enterprise hospitals, of which hygines were 2913,managers were 273. Of those hygines: professional title ratio was 1:4:6, educational background proportion was 20%, 41%, 37%, average age was 38, doctors and nurses ratio was 1:0.80. Total cots were 2715, Steady properties was 286.90 million yuan, large medical facilities were 951,common medical facilities were 1589, utilization rate were low in common, mean cots utilization rate was 57.26%. In 2002, outpatients were 2221259, inpatients were 42916. Total income was 232.60 million yuan, of which service income 117.69, money come from enterprise 86.63, service income accounted a percentage of 51% of tatal income, the latter 37%, total income in 2002 was 220.57 million yuan, of which salary 51.36, buying medical facilities 13.45, fare for medicine 102.29, remain 12.03.In investigation, we found that 75% enterprise hospitals have joined in community heath service, 14 of them have joined in medical insurance (35%), 15 of them agree on seperation (38%), enterprises's agree rate was 55%, The reasons of disagreement maily were: afraid they can't survive after seperation, with worse basic facility and lower level technician, they thought they are difficult in competing with local hospitals, afraid of lost steaty service corhot. The difficulties of seperation they thought were: who would the hospital belong to, how to arrange the workers, where would financition come from after seperation etc. They all realized that seperation is a trend, most hospitals have prepared for it. But some people can't understand why they must do so. Most people thought medical insurance a good policy, only that it is not matured at present. There are disadvantages, difficulties and advantages about enterprise hospitals. Disadvantages: Hospital's manage mechanism are born insufficient; the leaders have no independent rights; haven't form an operating manage mechanism; services is the only important thing, there are no cost-effect realization; utilization rate in human resources, properties and facilities are low, materials ares wasted seriously; technical level were worse, hygine talents lost seriously; hygine resouces couldn't be used fully and suitablely; configuration of health resources is unsuitable; there are no inspiration ,hospital vigorous are far less than local hospitals. Difficulties: Many enterprise hospitals located in folk regions, it is closed in geography and limitied in sevice crowd; their competition are weak. However, the whole circumstance is that health sevice supplies are larger than demand in Shi jiazhuang. Enterprise hospitals have formed a custom of waiting, demanding and asking in past years. So it is commonly that they woul... |
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