Study On The Evaluation Index System For Hospital Reimbursement Capacity

Background: The reimbursement capacity of hospitals is directly related to that thecost of economic activities of hospitals can be compensated or not, which is reallyimportant. At the same time, the evaluation of reimbursement capacity is an effectiveway to improve the capacity and the management of hospitals. Therefore, how toevaluate the reimbursement capacity scientifically, accurately and validly become thekey part of our current reform. However, it shows us that the research on the evaluationof reimbursement capacity in China is started relatively late and is still at the initialstage of exploration based on a literature study. Also, scholars just do some qualitativetheory researches, which mean that deep, systematic, scientific quantitative researchesare still needed and a mature method and system of the evaluation of reimbursementcapacity for hospitals also have not been formed. So, the study on the evaluation indexsystem for hospital reimbursement capacity is conducted and how to evaluate thereimbursement capacity scientifically, accurately and validly is discussed, which notonly provide evidences for hospital reimbursement content and evaluation, but also forthe government’s further reform of hospital reimbursement reform.Objective: In order to establish an instrument of reimbursement assessment which is fitto the effective valuation of hospital reimbursement capacity in China, this research isproceeding from the actual demand of hospital management, taking scientific theoriesand methods as the guidance, and following the principles of scientificity, systematicitycomparability, orientation, etc.Method:(1) Through literature review, the connotation of reimbursement capacity forhospitals is defined, the reimbursement evaluation indexes are concluded, and the reimbursement evaluation index system of hospitals is established initially;(2) Thereimbursement evaluation indexes of the system are first selected by using the methodsof Factor Analysis, Correlation Coefficient, Clustering Analysis. Then Delphi Method istaken to organize three rounds of specialist consultation, specialists’s opinions aresummarized, indexes are screened and modified, and the reimbursement evaluationindex system of hospitals is established eventually;(3) The weights of the index systemare calculated by AHP;(4) The reliability analysis and consistency test are conducted tocheck the reliability and test the consistency of the evaluation index system for hospitalreimbursement capacity, combined with statistical methods, trying to ensure that theconstructed system is scientific, accurate and reasonable.Result:(1) After several rounds of index selection, the study establishes an evaluationindex system for the hospital reimbursement capacity, which is comprised of fourindexes on the first level and twenty-three indexes on the second level;(2) All of theindicators of the system are weighted and quantified;(3) The reliability analysis andconsistency test are conducted to check the reliability and test the consistency of theevaluation index system for hospital reimbursement capacity.Conclusion: The evaluation index system for hospital reimbursement capacityconstructed by this study is scientific and feasible, which provides an objective,systematic and manageable instrument for the reimbursement capacity appraisal ofhospitals. It does not only offer evidences for hospital reimbursement content andevaluation, but also for the government’s further reform of hospital reimbursementreform. However, the study is still in the primary stage of exploration because theevaluation of hospital reimbursement is a highly comprehensive, widely involved job (itinvolves almost all aspects of the hospital management). Futher study will be graduallyconducted in the future. Also, owing to the limitation of the fund, study time, relevant information and knowledge, evaluation index system for hospital reimbursementcapacity constructed by this study needs to be revised, and we do hope it will begradually improved in practice.