Research On Hospitals' Social Responsibility In China: Behaviors, Index System And Advancement Path

Literatures show that the theoretical research and practice activities of hospitals'social responsibility (HSR) in China are both in the initial stage. Under the background of China's unique institutional, cultural circumstances, and the critical period of the new health care reform, it is so urgent that the theoretical issues related to HSR in our country should receive immediate attention. Moreover, the practice of HSR also requires corresponding rules and regulations to guide and lead.Under the guidance of related theories of HSR, this paper suggests that the essence of HSR means delivering social benefits. Besides maintaining its own survival and development, HSR means obligations of hospitals in maintaining public health, ensuring the quality and accessibility of medical services, accomplishing the government mandatory mission and other activities and programs to increase social benefits.Using content analysis, literature review, the Delphi method and analytic hierarchy process, this paper puts forward that the behaviors of HSR in China are mainly embodied in the following thirteen aspects:providing high-qualified medical services to patients, bad debt, tax, undertaking rescues under emergencies, accomplishing government mandatory missions, environmental protection, health services with external positive effects, with favorable price, granting low-profit medical services and cheap drugs, charity care, education and research, health improvement and health education, and actively involved in social welfare activities. Among the above thirteen items, the first six belong to the primary HSR, the seventh to the ninth are the intermediate HSR, the last four are the senior HSR. The twenty-first indicators and weights of quantitative evaluation index system of HSR are as follows:Donation (0.1653), health care lectures (0.1262), price discount (0.1086), voluntary treatment (0.0867), average medical expenses per inpatient (0.0859), research papers (0.0662), outpatient visits of prevention and health care department (0.0521), average medical expenses per outpatient (0.0489), expenditures of undertaking government mandatory missions (0.0410), emergency expenditures (0.0390), expenditures in education and scientific research (0.0367), environmental protection expenditures (0.0354), nosocomial infection expenditures (0.0299), intern visits (0.0242), the survival rate of critically ill patients (0.0111), tax (0.0111), discharge and admission diagnose accordance rate (0.0098), bad debt ratio (0.0080), the annual visits of outpatients(0.0052), patient satisfaction (0.0049), sterilized surgical wound infection rate (0.0038).Currently, the behaviors of HSR implemented by the hospitals are as follows by quantity digressive tendency:providing high-qualified medical services to patients, education and research, undertaking rescues under emergencies, accomplishing government mandatory missions, actively involved in social welfare activities, price discounts, charity care. Accomplishing government mandatory missions and undertaking rescues under emergencies show a strong relationship, especially in public hospitals. For public hospitals, the four senior behaviors of HSR (charity care, health improvement and health education, education and research, and actively involved in social welfare activities) are found significantly interrelated. However, there is not interrelated relationship in private hospitals.The result of empirical research on different hospitals suggests that public hospitals' fulfillment of HSR was obviously better than the private hospitals; considering the total amount, all levels or the seven kinds of specific behaviors, the number of third-grade hospitals' performance was higher than the second-grade hospitals. As the orientation, function, size, etc. between the third-grade and second-grade hospitals are different, the third-grade hospitals are supposed to take more HSR generally. Behaviors of HSR in eastern, central and western regions show difference in the total amount, but there is no statistical difference in the specific behaviors for the majority.According to part of hospitals' social responsibility evaluation index, this paper analyzes the fulfillment of hospitals' social responsibility in health care industry of China and Jiangsu Province at macro level. From the macro data point of view, China and Jiangsu Province had a good performance on hospitals' social responsibility, which plays a huge role in improving the health of residents. In contrast, the price of medical services increased year by year and it had become one of the most dissatisfied factors about the industry until 2009.Based on the results of empirical research and analysis of influencing factors, this paper examines the path and policy recommendations to enhancing level of HSR from the government, hospital, and social aspects.The main contributions of this paper are to sort out the nature and definition of hospitals' social responsibility, to examine the behavior and evaluation index system of hospitals'social responsibility and to analyze the classification, characteristics and relationships of the behavior. All this will make a great contribution to promote the study of hospitals'social responsibility. Part of the empirical findings and the research results can be uses as references for health care management.Owing to the data sources and other factors, this paper is still at a preliminary stage yet to be conducted. Firstly, the study of hospitals'social responsibility in China has just taken a step, so this paper might not have sufficient theoretical background and therefore might not provide compelling arguments. Secondly, this paper mainly uses various qualitative methods and supplemented by quantitative methods, comparatively the methodology is not as advanced as expected. Thirdly, data in the empirical research is collected from published information in the media, so the external validity is restricted.