Evaluation Of New Mechanism Of Public Welfare Economy Operation In Chengdu Public Hospitals

Objective : The goal of comprehensive reform of public hospitals is public welfare.The difficulty lies in building a new mechanism for the economic operation of public hospitals around public welfare.In this paper,by constructing evaluation index system of economic mechanism of public hospitals,adopts the quantitative method and quantitative method,six hospitals in chengdu city as a typical case,a systemic evaluation of the comprehensive reform of public hospitals of chengdu economic operation in the process of social effect and economic effect,discusses the public hospital public welfare economic operation mechanism of "difficulty and high cost of treatment" policy.This paper provides empirical evidence and reference for further deepening the comprehensive reform of public hospitals,improving the economic operation mechanism,and establishing the modern hospital management system.Methods:Based on literature review and expert opinions,an evaluation index system for the new mechanism of economic operation of public hospitals was established.,which includes11first-level indicators and42second-level indicators.Preliminary research results of the evaluation criteria group were used.Financial data and non-financial data of six public hospitals in Chengdu(2city-leveland4county-level)from December2014toJune2018 were collected.Employees,outpatients and inpatients were investigated.Meaning:Collected the literature about the comprehensive reform and operation mechanism of public hospitals at home and abroad.Non-quantitative method and quantitative method are adopted.Excel2012,Spss21.0,Eviews6.0and other statistical analysis software were used to establish the database,and descriptive analysis,correlation analysis and panel regression equation analysis of the data were carried out.Results:(1)Social effects:The sample public hospitals basically completed the construction of the comprehensive reform system,but the financial compensation,medical service prices,medical insurance payment and other supporting systems need to be improved after the cancellation of the drug addition;compared with the reform,the public hospital staff,outpatients,hospitalized patients satisfaction There was no significant change in the evaluation;the service capacity of public hospitals was significantly improved,the control of medical expenses was stable,and the proportion of medicines was greatly reduced,but the effect of graded diagnosis and treatment and average hospitalization days was not obvious.(2)Short-term effects are as follows: lower drug revenue and drug cost,higher technology value income and lower management cost,which meet the policy expectations;however,the increase of inspection and acceptance,material income and material cost fails to meet the policy expectations.The long-term effect is that the expenditure of 100 yuan drug income increases to achieve the policy expectation,but the hospital business balance rate,medical balance rate,net fixed assets rate,the decrease of financial subsidy income and the increase of material fees and medical receivables turnover days of 100 yuan income fail to achieve the policy expectation.(3)The policy impact of the new mechanism is mainly reflected in the fact that there is no significant relationship between the increase of the value income of technical services and the solution of "difficulty in getting medical services",but there is a significant negative correlation between the solution of "high cost of medical services".There is a significant negative correlation between the reduction of the proportion of administrative cost structure and the solution of "difficulty in getting medical treatment",But it can not explain how to solve the problem of "expensive medical treatment" is the most important factor affecting the operation effect.Conclusion :First,the comprehensive reform of public hospitals is effective in alleviating theproblem of "difficult and expensive access to medical services",which is reflected in the increase of service capacity and the reduction of medical expenses and drug proportion.Second,the comprehensive reform of public hospitals has basically broken the old mechanism of "supporting doctors with medicine",and the short-term effect is reflected in the reasonable control of medical expenses.The long-term economic effect is reflected in the reduction of drug fees in the medical income of 100 yuan and the obvious improvement of the balance rate of business income and expenditure.Third,the satisfaction of all stakeholders in the comprehensive reform of public hospitals still needs to be further improved.All in all,the satisfaction level of employees,outpatients and inpatients in the sample public hospitals was above the average.Each interest subject is less satisfied with the hospital’s existing environment,medical service awareness,work efficiency and hospital staff’s sense of identity.Suggestion:(1)Further consolidate the new mechanism for public welfare economic operation in public hospitals.External policies should improve supporting measures such as finance,price,and medical insurance.Internal management should strengthen overall budget management,cost control,financial reporting,and compensation reform systems,and organize the management,use management,evaluation management,information management,and supervision and management.Financial procedures ensure the effective implementation of medical business activities,and achieve public welfare and refined management of public hospitals;(2)Strengthen Party building in public hospitals,give full play to the leading core role of Party committees in public hospitals,and strengthen Party leadership in public hospitals.Consciously keeping a high degree of consistency with the Party Central Committee with Comrade Xi Jinping as its core in ideology,politics and action,fully implementing the Party’s theoretical guidelines,lines and policies,guiding andsupervising hospitals to abide by national laws and regulations,safeguarding the legitimate rights and interests of all parties,and ensuring the correctness of the direction of hospital reform and development.;(3)Establish a public hospital corporate governance mechanism.Promote the integration of functional departments and integrate various medical resources at all levels;Reform the employment of medical institutions’ personnel system,and implement "setting posts according to needs,competitive recruitment,employment according to posts,and contract management".In terms of management system,it adopts vertical and tight type to implement unified management of internal personnel,financial and material resources of medical institutions.;(4)Promote the construction of modern hospital management system.Formulate hospital articles of association,standardize internal governance structure and power operation rules,and improve hospital operation efficiency.Improve the decision-making mechanism of the hospital,ensure that the intention of the party organization is fully reflected in the decision-making,and give play to the role of experts in hospital management.We will improve the system of democratic management and ensure that workers and staff participate in democratic decision-making,management and supervision.We will improve the management systems for medical quality and safety,human resources,financial assets,performance appraisal,personnel training,scientific research,logistics and information,and improve the scientific management of hospitals.Strengthen the construction of hospital culture,shaping the industry clean breeze.We will fully carry out services that are convenient to and benefit the people and build a harmonious doctor-patient relationship.(5)Deepen the comprehensive reform of public hospitals and improve the quality of modern medical service system.In order to further enhance the sense of access,happiness and responsibility of the masses and alleviate the contradiction of unbalanced development in the field of medical and health care,public hospitals should assume the main responsibility for the reform of operation mechanism and implement the construction of high-level public hospital system and high-quality innovative mechanism.