Performance Evaluation Of Comprehensive Reform Of Public Hospitals In Hangzhou

ObjectiveComprehensive reform of public hospitals has been carried out in cities across the country.As a national pilot city of public hospital reform,Hangzhou has made initial achievements in advance.This study is aimed to evaluate the performance of the reform and provide reference for non-experimental areas so as to accumulate experience for further reform.Above all,this study explored many theories,such as performance,assessment,public policy evaluation and so on.And it managed to clarify concepts and shortcomings as well as define methods which are applicable to the field of public policy assessment.Meantime,this paper also made an empirical study on the comprehensive reform of public hospitals in Hangzhou so as to propose some reasonable Suggestions.MethodsThis research conducted many methods,such as literature research,reflexive design and time series analysis,which retrospectively investigated the effect of comprehensive reform of public hospitals on medical service efficiency and medical service cost.Via using discontinuous time series,this paper separated the policy effect,levels before reform as well as changing trend before and after reform.Meantime,it also managed to clarify policy performance through comparison.ResultsThe reform had a significant impact on many aspects,such as average daily outpatient emergency visits,per capita outpatient costs,average outpatient costs,drug revenue share,antibacterial drug use proportion,outpatient drug costs,inpatient drug costs(P < 0.05)and so on.After the reform,these elements showed a long-term downward trend.The average hospital stay,the utilization rate of hospital beds and the ratio of essential drugs have developed to a reasonable level before the reform.Currently,the policy impact is not statistically significant(P > 0.05).But the reforms have,to some extent,accelerated the pace of development.ConclusionsGenerally,the overall effect of the reform was remarkable,and the goal of "Prevent hospitals from selling drugs to make money for themselves " was basically achieved.Meantime,the rising trend of medical expenses has been curbed.Moreover,the integration of medical care and maintenance has achieved remarkable results,which alleviated the difficulty in getting medical treatment.In addition,the structure of drug use was gradually optimized,which helped to control irrational drug use.SuggestionsFirstly,establish new mechanisms by combining innovation with institutional linkage.Secondly,build hierarchical medical system which is adapted to local conditions.Moreover,use smart medical care system to properly plan medical resources at all levels in the region.In addition,hospitals need to improve their management and to tighten the control of cost.In the end,it is better to accelerate the exploration of talent incentive mechanism to cope with the competition of social capital.