| Health is an important part of fundamental human rights. As a main body of a healthy industrial investment, the hospital is the health care institutions that provide treatment and prevention for protecting people's health. Hospital is the public welfare service industry, the purpose is to rescue the wounded and save the people's life. Development of medical services is relative to the interests of the people, at the same time, it is the main topic of the harmonious development of society.Throughout the 20 years history of health care reform, health care market competition showed a more and more increasingly intense tendency, the situation of sharp competition make most of hospitals try their best to develop their own competitiveness. After the factor-driven or investment-driven, many wise hospital managers are aware that how to foster hospital competitiveness according to the hospital's nature and location. Especially accession to WTO, with the integration of domestic and foreign health care market, which makes our hospitals face increasingly tough competitive environment, compared with foreign hospital, domestic hospital is not lack of competitive conditions and advantages, but lack of effective competitiveness. Any one of hospital does not own competitive advantage, just as a ship that lacking sustained power, will be stranded or sunk sooner or later. Only in a way of improving competitiveness quickly, efficiently and orderly, can hospital survive and develop in a fierce competition of health care.Hard to see a doctor, high medical cost has become a hot topic. Along with the development trend of economic globalization, China's health care market will be gradually opened to the world,the substance of the competitive market economy is competing for market competition. In particular, with the rapid changes in the medical environment and policy, with the quickly upgrade of medical technology and medical needs, how to enhance hospital competitiveness has become a very important and concerning topic.However, hospital competitiveness is a complex systematic engineering, which covers economics, management science, systems science and other fields of knowledge, and which is not only a social problem, but also an economic issue. In the thesis, based on evaluation theory, the competitiveness theory, and hospital management theory and combined with some specific hospital, identified the key factors that affect the hospital competitiveness, studied the hospital competitiveness by the method of system dynamics, management statistics and rough set theory. Based on it, put forward practical significance of management measures, which not only provides a new strategic direction and diversification of new thinking for hospitals, but also make hospital better take its advantage and avoid its weaknesses for facing the social environment impact and challenges.The research achievements in the dissertation are follows:1. Constructed competitiveness evaluation index system based on the three A-level comprehensive hospitals in Jiangxi province.The dissertation takes the three A-level hospitals in Jiangxi province as the research object, based on the hospital survey and system analysis about the 14 three A-level hospitals, gave a detailed analysis of the reality of three A-level hospitals in Jiangxi province, by the method of SWOT tool, introduced the strengths, weaknesses, threats, opportunities and portfolio strategy of three A-level hospital. From the analysis of internal and external factors of hospital, the dissertationestablished a set of targeted, scientific and systematic evaluation index system from the resource capacity, clinic capacity and managerial capacity combined with concrete situation of hospital in Jiangxi province.2. The dissertation proposed a new reduction method and applied it in the research of three A-level comprehensive hospitals in Jiangxi province, obtained the key evaluation index.The dissertation introduced the concepts of rough set and it's theoretical knowledge, introduced the feasibility of applying the rough set theory in evaluation hospital competitiveness based on being compared with other evaluation methods. On the basis of other reduction method, the author proposed a new reduction method with further studying the reduction method------reduction method of order-cycle column remove based on indiscernibility relation and applied it in the research of three A-level comprehensive hospitals in Jiangxi province, obtained the key evaluation index from the resource capacity, clinic capacity and managerial capacity of hospital, calculated the importance degree and weight of the key indexes, then constructed evaluation model and obtained the ranking of the 14 three A-level hospitals.The ranking result is consistent with the concrete situation of the hospital in Jiangxi province, which is agreeable with some relevant experts. At the same time, the author applied the reasoning of making decision rule of rough set in the evaluation of hospital competitive ability, the idea is that on the basis of reduction to extract key index and obtained the making decision rules according to the theory of the reasoning of rough set, which can decrease the expense of evaluation and simplify the complexity of knowledge base of expert system, and improve the efficiency of evaluation.3. Accoring to the research in the concrete hospital built nine system archetypes based on the Peter. Senge's archetype analysis technique.The research must take hospital concrete situation and management theory into account, with doing some survey in the concrete hospital, can accurately identify the specific hospital bottlenecks that restrict hospital development. Only combined the specific problems with the hospital management of the theoretical methods, systemetic methods, can truly find the countermeasures and policy of improving the hospital development. System dynamics (short for SD) approach is an effective way to study complex problems. For better analyzing the competitiveness of three A-level comprehensive hospitals in Jiangxi Province, the study members of hospital competitiveness made lots of specific survey in the 14 three A-level hospitals, three B-level hospitals, two A-level hospitals, two B-level hospitals, private hospitals, Chinese medicine hospitals, Chinese and Western medicine hospitals, some specialist hospitals, and so on. On the basis of Peter Senge's archetype analysis technique, the author collated the information that researched in the hospitals for study of hospital competitiveness for five whole months, built 9 system archetypes of effectively enhancing the public hospital competitiveness, and obtained the targeted strategy after analysis, which provides a theoretical basis for hospitals and hospital management to conduct related research.4.In-trees archetype generating set analysis based on the hospital competitiveness evaluation index system.The dissertation built 9 level-rate units and 9 level variable-into-tree models based on the sub-index of hospital competitiveness evaluation index system and standardized modeling method——in-trees archetype generating set method. Then the author qualitatively analyzed feedback dynamics complex relationship between all indexes, with the actual situation of hospital, constructed some typical feedback archetypes, and proposed targeted countermeasures.5.Combined the feedback loops calculation method of SD with computer knowledge, realized that computer calculate the feedback loops by means of advacnced computer compiling language visual c++6.0.Determination of the number of feedback loop is the basis of SD model analysis and simulation analysis. Any complex issue in human society is constituted with a lot of balancing feedbacks and reinforcing feedbacks.It is necessary to determine its collection of feedback loops when analyzes the system dynamically,which is very improtant to analyze the structure of this system,establish the archetype,regulate model and simulate. There are many methods to calculate the feedback loop, such as branch vector determinant method and branch vector matrix method. In this dissertation,combined the feedback loops calculation method of SD with computer knowledge, realized that computer calculate the feedback loops by means of advacnced computer compiling language visual c++6.0. Then applied it in the concrete example of the thesis, calculated the feedback numbers of nine level variable-into-tree models through running the program,which further revealed complex dynamic feedback relationship between the variables.6. On system dynamics simulation research based on Jiujiang Chinese Medicine hospital (short for JJCMH)In the dissertation firstly introduced the concept of system simulation, level variable equation, rate variable equation, assistance variable equation, added variable equation, exogenous variable equation, endogenous variable, table function and delay function. Based on the investigation and systemic analysis in JJCMH, according to the theory of SD, set up 7 flow-rate-into-tree models, described the idea of model building, defined all variables in the model, and descript its mathematical equations. Then put simulation models and simulation equations into simulation software vensim, analyzed simulation results and simulation charts. Meanwhile, obtained the new simulation charts based on countermeasure implementation and parameter control, which help to compare the new simulation charts with the former simulation charts.Thanks for funding projects:1.graduate of innovation special funds in Jiangxi province 2008 (YC08A004):on the research of the hospital competitiveness system evaluation and SD simulation of improving countermeasures——take Jiangxi province as an example.2. Health Department soft science funds in Jiangxi province 2008.(20082039):on the research of the hospital competitiveness system evaluation and SD simulation of improving countermeasures. |
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