| The medical and health industry has its particularity.Under the condition of market economy,public hospitals generally produce profit-seeking behaviors,which makes the problem of "difficult and expensive to see a doctor" one of the hot issues that people pay most attention to,leading to deviation of public welfare.The government has always taken the reform of public hospitals as the top priority of all previous medical system reforms.Adhering to the public nature of third-level public hospitals is of great significance to social stability.Tertiary public hospitals,as the most important part of public hospitals,should be people-oriented,fundamentally establish the concept of serving patients,focus on alleviating the problem of people seeing a doctor,and set an example for the return of public hospitals to public welfare.Through literature research,this paper analyzes the status quo of the public welfare of the tertiary hospital in Shandong Province.First,it further explores the factors that cause the deviation of the public welfare of the tertiary public hospital in Shandong province by comparing the data of average medical cost per time,income and expenditure of health institutions.Combined with relevant public hospital public welfare literature and social reality,the paper preliminarily summarizes the influencing factors of the public welfare of tertiary public hospitals in Shandong Province,and divides the indicators into three levels.Secondly,relevant experts were called for interviews to conduct scientific analysis of the summarized influencing factors,remove unreasonable factors and retain reasonable ones.After repeated discussion,27 effective indicators were selected.By understanding the basic composition of experts such as years of work and education,experts’ activeness and authority coefficient,to ensure the rigor of the preliminary work of the questionnaire.Two rounds of Delphi method were used to score each index.Among them,the coordination coefficient of the first round of Delphi method is low,and the consistency of experts’ opinions needs to be strengthened.According to the feedback of experts,the index is modified and integrated again,and the second round of Delphi method is carried out.The coordination coefficient is high,the results are reliable and statistically significant,and finally summarized into 18 effective influencing factors.The analytic hierarchy process is used to compare these factors in pairs and make quantitative analysis.The results show that the matrix meets the consistency test.It is found that factors such as the small amount of financial input,the failure of government compensation mechanism and the monopoly of quality medical resources of tertiary public hospitals have greater impact on the public welfare of tertiary public hospitals than other factors.It is necessary to analyze these important factors emphatically.Finally,combined with the status quo of public hospitals in Shandong Province and the summarized influencing factors,this paper classifies the influencing factors,which are mainly divided into improper macro-control of the government on the medical service industry,the defects of the hospital’s own operation,and the misbehavior of medical staff.Then,it makes a detailed analysis of the deep-level micro influencing factors.It is believed that the deviation of public welfare of tertiary public hospitals in Shandong Province is mainly caused by the imperfect compensation mechanism of government input,the government’s administrative monopoly on the medical industry,the imperfect hierarchical diagnosis and treatment system and the lack of moral restraint mechanism for medical staff.In view of these problems,this paper proposes to promote the return of the public welfare of the tertiary public hospitals in Shandong province by establishing a stable investment mechanism for public hospitals,promoting the comprehensive system reform of tertiary public hospitals and strengthening the construction of professional ethics of medical staff. |
PDF Full Text Request