Deepening The Reform Of Military Hospitals Following The Reform Of Public Hospitals In China

Public hospital reform is the key of the national medical health system reform. China started to implement the reform of public hospital in some pilot cities since February 2010.By June 2015 there are 17 pilot cities across the country and all the public hospitals at the county level will begin the reforming. By 2017 the reform of public hospitals may cover all the country. Military hospital is the special part of public hospitals, assuming the task to provide health service for both the Military and the civilians. Participating in the reform of public hospitals is objective. The pilot reform of public hospitals impacts the military hospitals mainly on those: it is not equal for the military hospital to get the basic construction investment and policy loss compensation and to take part in the regional health planning because national policy is not clear and the local governments’ enthusiasm is not high; internal understanding of the reform inside the military is not unified. Although the headquarter has a guidance, owing to lack of coordination with local government in place and lack of major policy of the reform of system, the reform practice of public hospitals is not unified, causing the military hospital participating the reform of public hospitals very difficult. Military headquarter leaders and organs of military attaches great importance to the military public hospital reform, having been studied the deployment of many times and specially arranged a program to research the reforming of the military hospital. This program led by my mentor and I have been participating in it as the backbone.The purpose of this study includs to grasp the new progress and the new requirements of the national reform of public hospitals, to further clarify the misunderstanding of military hospital to participate in the reform of public hospitals from the combination of theory and practice, to get out the contradictions and difficulties since the pilot reforming of military hospital of prominent, to summe up the pros and cons experience of pilot reform. At last, it aims to crack contradictions and countermeasures, to provide reference for decision-making of the general headquarters/departments, to provide guidance for military hospitals to participate in the reform, and to further enrich our theory system of military health service.This study uses such methods as literature research, questionnaire survey, statistical analysis, case analysis, SWOT analysis and system evaluation. At the end, we put forward a series of research results after a systematic in-depth study.Besides forewards and conclusion, the contents and results of this study research are divided into six parts:The first part does a whole analysis. First, make a summary and a analysis of the development trend of the civil-military integration and the ideology and practice experience can be used for reference from the health resource allocation and optimization, strengthen the civil-military integration collaboration; Second, making a summary and a analysis of thenew progress of the pilot reforming of public hospitals including the public hospital institutional reforming, the structure adjusting, the integration of resources, gradually optimizing medical service system, deepening the reform of personnel system, and strengthening the hospital internal management; Third, teasing out enlightenment of participating national reforming of public hospitals including military hospitals to join the local medical group, seeking for local government policy support, strengthening the hospital management, building discipline advantage and implementing drug zero price difference, according to the methods of investigation, questionnaire.The second part does a theoretical research. First, analyzing the differences between military hospitals and national public hospital from a functional task, business nature, funds safeguard system, supervising system and the allocation of health resources. Second,analyzing the influence factors of military hospital to participate in the reforming of public hospitals from the aspects of the different understanding of the ideological concept, the acceptance of local department, the interests game between the two kinds of hospitals, the determination of the high-level decision-making departments in the state and army; Third,by using the SWOT analysis method, analyzing the advantages, weaknesses, the opportunities and challenges of military hospital to participate in the reform of public hospitals.The third part does a case analysis. We select three typical military hospital as examples including the Second Military Medical University Hospital, the 359 th Hospital of Nanjing Military Region and the 105 th Hospital, carrying on the thorough analysis mainly from the local public hospital reform policy, the participatory experience in the practice of the reform of military hospitals, and the contradiction problem. Successes include primarily:good support of local policy, the unit’s actively striving, earnestly implementing reforming required on the premise of keeping the army characteristics; The main problem includes: the reform of military hospitals is not included by the local government, and cannot enjoy the same support with public hospitals, due to the nature of the military hospitals.The fourth part analyzes the contradiction and problems about military hospitals to participate in the pilot reform of public hospitals. Through the 15 hospitals participating summary analysis of the pilot reform of public hospitals, teasing out the contradiction of eight aspects, including: policy problems due the special nature of the army hospital to participate in the reforming; market share dropped sharply due to implementing regional health integration; profit margins are squeezed due to compensation mechanism has not yet been established; the talent team construction is difficult to integrate due to being restricted by objective conditions; the long-term development is restricted due to hospital construction lack of support; competitive pressures continue to increase due to encouraging medical access diversifiedly; system is not compatible to meet each other due to information platform of information.The fifth parts puts foward six countermeasures, according to the characteristics of military hospitals and actual condition in pilot cities carrying out reform of public hospitals,combining the contradiction problems in the pilot, including: setting up perfect flexibly joint coordination mechanism by strengthening the top-level designing; integrating into the national regional health planning by active innovation; establishing a perfect compensation channels by find various ways; spotting talent construction problems by striving for policy support; improving the overall market competitive power by giving full play to the advantages of the army; adhere to the connotation development by strengthening the scientific management; and building information exchange platform by optimizing the information system.The sixth part does an evaluation on the countermeasures for military hospitals to participate in public hospital refoem, summarizes seven measures and puts forward three categories incluing the state-leading, military following up and hospital self-discipline, and eight projects including organization and coordination mechanism, regional health planning,policy loss compensation, staff welfare, military corresponding business support, medical service model, construction technology, informationization construction, and 16 points including military hospitals should be brought into the national overall plan reform of public hospitals, establishing coordination organization and work system, unified planning paid service policy in the allocation of resources utilization, the same as the public hospital,with headquarters in public hospitals dislocation development. Using Delphi Method and consulting 13 experts selected from organs engaged in management of military hospitals,that to participate in the reform of public hospitals and are familiar with the reform policy.First, we compare the three levels of weight, and then evaluate scientific, feasibility, and effectiveness about the 16 points, thus form the evaluation system and evaluation results of the countermeasures. At last, we adjust the 16 points according to the consulting data and statistical analysis.