| Background In recent years,under the strategy background of building an innovative country,with the continuous deepening of the national health care reform,the medical management system is undergoing a continuous course of optimization and innovation.In order to comply with the situation,many big hospitals in China have started the research-oriented hospital construction,which has attracted great attention from academic fields and hospital managers;However,so far,little is known in the investigation about the basic situation,construction progress,development model,construction achievement,and et al in military research-oriented hospital construction.Purpose In present study,we aim to investigate the current situation of pilot hospitals,conduct a comparative study on hospital situation of different levels before and after pilot construction,and carry out the simple achievement evaluation in military research-oriented hospital construction,in an attempt to discover the existing problems,point out the confronted difficulties,provide referential countermeasures and suggestions for the military hospital managers,and to promote military hospitals' transformation and sustainable development in new period.Methods The 25 military hospitals were divided into two groups according to the establishment scale,including 16 division-level hospitals,and 9 regiment-level hospitals.Information about the research-oriented,team construction and hospital operating mechanism was collected with self-made questionnaires,and various data of the pilot hospitals was gathered from the 'Hospital Statistic Data' between 2010 and 2014,issued by the Health Ministry of the General Logistics Department.According to the hospital levels of division and regiment,a comparative study was carried out to explore the difference before and after the pilot construction.Changes from 2010 to 2012(before pilot construction)was recognized as the control group and changes from 2012 to 2014(after pilot construction)was recognized as the experimental group.Excel software was used to establish the database and SPSS18.0 software was employed for data analysis.The main statistical methods include descriptive statistical analysis,rank test and et al.Results It was shown that the division-level hospitals didn't encounter significant extensive changes in the increasing range of outpatient(z=-0.052,P=0.959),emergency and hospitalization quantity(z=-0.259,P=0.979),while made significant achievements in intensive construction,including the rise in the number of intractable cases(z=-2.275,P=0.023)and complex operations(z=-2.379,P=0.017),as well as the application of minimal invasive surgery(z=-2.999,P=0.003).In management efficacy,significant decrease was achieved in average length of stay and drug proportion(z=-2.043,P=0.041;z=-2.017,P=0.044).In innovation construction,the division-level hospitals,mostly with medical special department centers and key laboratories had significant increase in publication of SCI papers(z=-3.524,P<0.001).In team construction,most staff of master series in division-level hospitals were with education degree of post graduation or higher.In hospital investment,significant promotion was achieved in medical instruments(z=-2.534,P=0.011),information construction(z=-2.329,P=0.020)and research funds inputs(z=-2.844,P=0.004).It was shown that the regiment-level hospitals encountered significant increase in outpatient,emergency and hospitalization quantity,with the most increase in hospitalization quantity(z=-2.073,P=0.038).In intensive construction,a significant promotion was made in the application of minimal invasive surgery(z=-2.666,P=0.008),while no significant increase was achieved in the number of intractable cases(z=-1.260,P=0.208),complex operations(z=-1.481,P=0.139)or rescue success rate(z=-0.415,P=0.678).In management efficacy,significant decrease was achieved in average length of stay(z=-2.100,P=0.036),but not in drug proportion(z=-0.059,P=0.953).In innovation construction,significant increase was achieved in publication of SCI papers(z=-2.552,P=0.011),while with limited whole numbers.In team construction,staff of master series with education degree of post graduation or higher took a proportion less than 20%in more than half of the regiment-level hospitals.Besides,the regiment-level hospitals had few leading subjects and no significant increase was achieved in the number of high level research projects(z=-1.653,P=0.098).In hospital investment,significant increase was achieved in whole medical instruments input(z=-2.192,P=0.028),while not in information construction or research funds inputs(z=-0.652,P=0.515).Conclusions The division-level hospitals have clear establishing direction,and more moderate development scale.The division-level hospitals' management efficiency enhanced,and the connotation of quality improved significantly.The division-level hospitals'innovation strength is stronger,and the military leading status was consolidated.The division-level hospitals' investment was precisely powered,and main body of construction was continuously optimized.The regiment-hospitals' services increased in the number,and the connotation of quality slow raised.The regiment-level hospitals' diagnosis and treatment efficiency was improved,but the structure adjustment of diagnosis and treatment was adverse.The regiment-level hospitals'discipline construction was weak,and the talent team construction was insufficient.The construction of research-oriented hospitals could help to increase academic status,intensive quality and work effciency,as well as to promote management efficacy,innovation activity and the transformation development of the hospitals.However,for regiment-level hospitals,the current construction period might be inadequate.The problems encountered in the construction work include in balance development of research and innovation ability,inadequate communication between military and local or international medical fields and reduction in reasonable supervision.It was suggested for superior management departments that measures like top-level design,classified guidance and scientific research construction help could be promoted.Strategy should be made to enhance the development of the military integration from the national level,accelerate the transformation of military hospitals and promote sustainable development. |
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