Study On The Construction Of Urban Public Hospital's Credit Rating System

ObjectiveIn this study, through the definition of credit and public hospital credit, to find out the status of their credit rating, analysis the characteristics of public hospitals credit evaluation system, determine the indicators and weights, in order to build a more focused, more practical urban public hospitals in the credit evaluation index system to provide a tool of hospital credit ratings for rating agencies, so as to achieve the purposes of strengthen the government's macro-control policy-making, guide medical institutions to enhance the image of their own credit, regulate the order of the medical market transactions, and make medical institutions operation healthful, effective and continuous. Ultimately this hospital credit evaluation index system can promote the development of China's public health.Methods1. Literature researchThrough Medline, CBM, CNKI, Internet to search the monographs and academic papers and other documents of domestic and international credit rating, understands the domestic and international credit rating of the study, defining the concept of hospital credit and anglicizing the difference of credit evaluation between hospital and corporation.2. Delphi methodChoice 23 experienced experts in the field of related research, mainly from the Ministry of Health, City (District) Health Department, and School of Management College of Health, the leading of public hospitals, the Centers for Disease Control and other research departments. According to experts of the academic qualifications, job title, professional background, work experience to engage in health management, calculate experts familiar with the coefficient, authority and determine factors and so on, and select the primary indicators by two rounds of expert consultation.3. Analytic Hierarchy ProcessUse Delphi method in the calculation of the weight of the first and second level indicators, combined with AHP (Analytic Hierarchy Process, AHP), calculate the weight of the third level indicators to form the credit evaluation model. 4. Questionnaire surveySelect four public hospitals in Wuhan regions, Hubei Cancer Hospital, Tongji Hospital, Xiehe Hospital and Xinhua Hospital, designed the basic situation of the hospital questionnaire, medical and nursing staff satisfaction survey, patient satisfaction and reactive questionnaire, random survey 129 health care workers and 276 patients, and collected data, analyzed the original data and according to the weight of indicators at all levels to calculate the credit value of the sample hospitals.5. Statistical analysis methodEstablish databases, entry and storage data, through statistical analysis, testing the index system of the reliability and validity, the reliability is the degree of consistency, that is using the same method used on the same object when the results of repeated measurement. The main method of reliability analysis isαcoefficient (Cranach). The validity is the extent of measuring things which is accurately measured by measuring tools. Content validity use expert evaluation method.Results1. Hospital credit is a social evaluation which is about the capacity of performing hospital duties by Life-saving of the hospital, prevent and cure diseases, protect the health of citizens, as well as duties related activities. This evaluation is to be existence in the patients and medical services based on the exchange, the inside and outside the hospital environment, the basic quality, management and social response to the main content, through its built-in specialized services, medical conditions, technical equipment for the patients and the community by providing medical care, emergency relief, dealing with accidents and work accidents, etc. A view to increasing the competitiveness of hospital markets, enhance the development of power hospitals to improve the community's hospitals, the goal of job satisfaction.2. The characteristics of public hospitals in credit rating: focus on the current interest, pay more attention to the development of long-term future and potential; in the settlement of the current first-aid work, pay more emphasis on exploring the far-reaching human health; focus on the health resources, pay more attention to rational use of limited resources; in the emphasis on quantity coverage, pay more attention to improving health care quality; in the emphasis on cost-effective, pay more attention to social benefits.3. Urban public hospitals in the credit evaluation index system are divided into three levels. The first level is the running basis, clinical effect and dominant effect of the three dimensions of credit; the second level is the secondary indicators, which include the running basis of the basic quality indicators and the development potential of the two dimensions, the clinical effect indicators include health care efficiency and quality of the two dimensions, the dominant effect include social benefits and social indicators two dimensions of responsiveness; the third level is the credit targets, 28 indicators for all.4. The first round of expert consultation to coordinate the overall coefficient is 0.276, the coordination coefficient chi-square test P value of less than 0.05; the second round of expert consultation to coordinate the overall coefficient is 0.326, the coordination coefficient chi-square test P value of less than 0.05, the second round of expert advice the level of coordination among experts is better than the first round, the result is desirable.5. Carried on the reliability and validity analysis to the indicator system, the value of Cronbach'sαcoefficient is 0.6524, the value of content validity is 0.76.Conclusion1. Hospital credit is a social evaluation which is about the capacity of performing hospital duties by Life-saving of the hospital, prevent and cure diseases, protect the health of citizens. Dimensions include running basis, clinical effect and dominant effect.2. Urban public hospitals in the credit evaluation index system have better reliability and validity, can be more effective and reliable evaluation of the credit situation of public hospitals.3. Urban public hospitals in the credit evaluation index system of strong operational and indicators of credit-related data collection more convenient, and the results of credit have a simple calculation.4. Urban public hospitals in the credit evaluation index system can reflect the level of overall credit, also analysis the results from the running basis, clinical effect and dominant effect, provide a basis for credit management.