The Research On County Hospital Medical Service Capability Evaluation In A Certain Province

Objective: This study through a survey of county hospital medical servicecapability in a certain province, to find out baseline level of county hospital servicecapability and to find out the problems existing in the construction of county hospitalmedical service capability, Analysis of the causes, and provide the reference for healthadministrative departments to make the decision to promote county hospital medicalservice capability.Methods: According to the regional characteristics to divide the province intothree districts the western, central, and south and according to cities (counties) firstletter order to number the county hospitals, A is for the west, the west have16countyhospitals and these county hospitals are numbered A1-A16；B is for the central, thecentral have16county hospitals and these county hospitals are numbered B1-B16; C isfor the south, the south have12county hospitals and these county hospitals arenumbered C1-C12.This study adopts questionnaire and qualitative interviews to gather countyhospital’s source. Use Descriptive analysis method and Comparative analysis method toanalyze the basic situation of county hospital beds and the county hospital medicalservice capability status quo; Use Lorenz curve and GIni coefficient to analyze countyhospital beds equity; Use AHP offer a comprehensive evaluation of county hospitalmedical service capability.Results:1.Each county hospital has389authorized beds and449open beds. Thebeds GIni coefficient is0.199; the beds GIni coefficient of the western, central, andsouth are0.151,0.177and0.168. There are13county hospital beds meet two levelshospital criterion and accounts for29.6%;54.6%of the county hospital fell short of twolevel hospital criterion;15.9%of the county hospital exceed two level hospital criterion. The size of the south county hospital beds exceeds the western and central.2. County hospital diagnostical capability are in the good level.2010Clinical andPathologic diagnoses is94.84%; Out and In Hospital diagnoses is92.89%;Three Daysdiagnoses is93.03%;Hospitalized Patients Rescue rate is89.39%;Emergency PatientsRescue rate is96.93%; Hospital Bed Occupancy rate is70.95%; Averaged length ofstay is8.52days.2008-2010except Three Days Hospital diagnose rate fell short of twolevel hospital criterion, the other indicators have reached two level hospital criterion.Hospital Bed Occupancy rate is rising from the same period last year. The south countyhospital diagnostical capability is better than the western and central.3.2008-2010, Proportion of county hospital established the medical quality andsafety control system are71.43%,71.43%,73.81%, that shows county hospitalgradually strengthened the medical quality and safety control. County hospital notestablished the medical quality and safety control system every one hundred number ofinpatient medical treatment disputes are6.76%,8.10%,7.47%; every one thousandnumber of inpatient medical accidents are77.03‰、96.78‰、49.16‰. County hospitalestablished the medical quality and safety control system every one hundred number ofinpatient medical treatment disputes are5.54%,7.73%,6.32%; every one thousandnumber of inpatient medical accidents are42.84‰,54.56‰,40.30‰.The two rates incounty hospital established the medical quality and safety control system are lower thancounty hospital not established the medical quality and safety control system.4. Comprehensive evaluation result: According to the general index (GI) countyhospital medical service capability is divided into three levels, high(GI≥35),middle(30≤GI﹤35), low（GI﹤30）.There are16county hospital medical servicecapability comprehensive evaluation result is high accounts for36.4%;54.5%countyhospital comprehensive evaluation result is middle;9.1%county hospitalcomprehensive evaluation result is low. The western, central and south county hospital’average GI are34.4,34.0,33.9, the difference are not very obvious.2010comparedwith2008hospital medical service capability comprehensive evaluation result (high、middle、low) growth rate are147.6%,32.3%,-79.4%,that explains medical resourcesvertical integration have improved the county hospital medical service capability.Conclusion:1.County hospital diagnostic capability is in the good level. Clinicaland Pathologic diagnose rate, Out and In Hospital diagnose rate, Three Days Hospitaldiagnose rate, Hospitalized Patients rescue rate, Emergency Patients rescue rate are allreached or almost reached two level hospital criterion. 2. Hospital beds equity according to the population distribution is good. Healthadministrative departments at all levels should constantly increasing medical and healthservices input to consolidating and developing the equity of the medical and healthresources.3. The investigation proved that Establish the medical quality and safety controlsystem is of importance to help hospital avoid for hospital medical risk.4. County hospital scientific research innovation ability need be further improved.Lack of long-term plan to introduce new medical technology, new medical technologylaunching rate is not high. Papers and monographs are fewer and the hierarchy is nothigh.5. Comprehensive evaluation result shows county hospital medical servicecapability is on high levels. Since implement medical resources vertical integration,county hospital medical service capability has been improved obviously.