| Background: more and more general hospitals applied to increase their beds, and view this aspect as one of their developed objects. Such an action like this lacks scientific evidence. And it is not fit for the rule of health resource planning. Also will it waste the resource? In order to avoid this blindness of following the increasing beds, following the max-scale of hospital, we apply this project.Objective: This project will research the most appropriate scale of bed according to the specific condition of China. It will find out the best composed unite of productive elements such as health manpower, equipment, etc, in one hospital at this level of scale of bed so that the hospital could realize the best running and the best administration. And it could make the resource be used more efficient and acquaint the better performance.Data: data of 7 general hospitals Ministry of Health of China subject or supervisory was collected, including economic, providing, capital, scientific & research, quality etc of 1990,1995 and from 1999 to 2002.Method: (1) Descriptive statistics was applied to bed and other health resources analysis of nationwide and data hospitals. (2) Factor analysis was used to establish the system of hospital output. (3) Productive function was constructed to analyze the scale-economic of data general hospitals.Result: (1) The result of productive function shown that the scale-economic of data hospitals were decreasing. And the bed size has the negative effect to the hospital scale-economic. (2) The increasing of hospital beds did not mean the promoting of hospital performance. The scatter plot analysis of hospital performance and hospital bed size revealed that when bed size increases, hospital performance increases, decreases, and then increases again. The result indicated that the top number of bed was 1100. (3) According to the result of factor analysis, hospital output included economic, medical service provide and health quality. And the representative factors were occupancy inpatient days, total income, number of outpatient, number of operating inpatient, diagnoses rate of three stay days, diagnoses coincident rate, first level cicatrisation rate, velocity of hospital bed and medical income. (4) The economic outcome of hospital is correlation with expenditure indexes mainly. The correlation coefficient of economic outcome and bed scale is 0.636, which listed at 36 of all 67 indexes. And the social outcome of hospital is correlation with employee indexes mainly. The correlation coefficient of social outcome and bed scale is 0.683, which listed at 40 of all 76 indexes.Conclusion: (1) Health resource inputs were increasing, but the more hospital resources were not the better quality. (2) The result of productive function shown that the scale-economic of data hospitals were decreasing. The too large bed scale is uneconomic as well as too small bed scale. (3) The utilization ration of hospital bed was higher than others', but it exists the unreasonable factors. These hospitals provided a high part of basic medical service, which were not the duties of them. It not only made the waste of health resource but also led these hospitals have no time to do the research. This action was not advantageous to the positive develop of hospitals. (4) The fee of medical was increasing followed the increasing of hospital beds. It made the medical expense burden of people and country more serious. (5) There was a distinction between city and county in possession of health resource. The embodiment of well-off society in health is not only the utter increasing of bed but also the distributing of the bed. (6) The performance of hospital does not improve following the increasing of the bed. There is a throw-line between the performance and bed scale. (7) It is feasible to confirm the exact number of bed in one hospital through the statistical methods. And it also can use the factor analysis to build the system of hospital outcome.Suggestion: (1) Government should do the macroscopically control through... |
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