Research For The Running Effect Of Public Hospitals In Karamay Under The Background Of New Health Care Reforming

Objective:The indicators of medical resources distribution, healthcare services and operational efficiency from 2010-2015 are compared both before and after the reformation based on the investigation of 4 reforming pilot public hospitals in Karamay, Xinjiang in the paper.The achievements and problems are analyzed in order to propose the countermeasure and suggestion for that government who makes the reformation policy about public hospitals in cities. Method:Applying quantitative analysis and qualitative analysis in distribution of medical resources and healthcare services both before and after the reformation in the research. Variation coefficient method are used to filter the indicators of operational efficiency of the reforming pilot public hospitals. Data envelopment analysis (DEA) is used to evaluate operational efficiency of public hospitals. Result:(1) There is an uneven distribution of public hospitals in Karamay. The superior medical resources are centralized in the central urban area. There is even no public hospital in Wuerhe. (2) Human resource:The total number of health care workers have been growing consistently year after year but the managers and handymen have been reduced or increased slowly at the same time. Main force are young and middle age and college-based academic structure.69.90% of medical workers are under 45,42.27% graduated from college and 39.33% from junior college, only 5.46% got Master’s degree. In the structure of academic title,40.30% of health care workers are the intermediate and 38.53% are junior develop, only 15.55% have senior professional title. (3) Income:Total income, financial subsidy, outpatient income, inpatient income and pharmaceuticals income have been increased year by year, but the percentage of financial subsidy has been declined gradually. (4) Expense:Total expense, Medical expense and administrative cost have been increased gradually. Administrative cost has been growing quickest.The average increase rate of administrative cost is 483.25% in tertiary-level hospitals and 505.19% in secondary-level hospitals. (5) Assets and liabilities:Total assets have been increased year by year. The number of large equipment have been increased gradually. Debt ratios have an increasing trend over time. However,the leverage ratio of most hospitals are under 50% and the current ratio has been raised steadily. (6) Bed utilization:Actual opened available beds have been increasing and the average hospital stays have been declining year by year. (7) Medical service:Total patients for diagnosis and treatment, medical examination, outpatient, hospitalization, operation have been increasing year by year. Reservation services developed quickly. The rate of reservation increase is 1268.06% in tertiary-level hospitals and 349.94%in secondary-level hospital. (8) Social efficiency and economic benefit have been increased generally and there are still some erratic fluctuation. Resource utilization are expected to improve in the future. Conclusion: The management mechanism have been developed in the creative way during the reformation of public hospitals in Karamay. The Hospital Management Bureau was founded prior to all the other regions in Xinjiang. A regional medical care information network and an "M-1-N" remote medicine platform were founded in Karmay. The medical resource have been increased, the service pattern have been optimized, the level of diagnosis and treatment have been improved and the Social efficiency and economic benefit have been increased over time. The experience of reformation in Karmay could be promoted to other regions in Xinjiang. But there are still some issues of the medical system in Karmay such as the distribution of public hospitals are unbalanced, the fiscal input is insufficient, the structure of human resource is irrational and the resource utilization shall be more efficient. The improvement proposals include establishing scientific and standard management system, ensuring the rational use medical resources, optimizing medical worker structure, improving compensation mode, enhancing diversity medical care organization and promoting Hierarchical system for diagnosis and treatment in order to improve the operating Efficiency of hospitals.