Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clin...Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clinical data from patients who received treatment in the Department of Orthopedics and the Department of Acupuncture and Moxibustion at our hospital from January 1,2023,to December 31,2023.The study compared the costs of medications,examinations,treatments,laboratory tests,nursing and other expenses,and total treatment costs between the two departments.It analyzed the cost structure of the two departments and proposed further improvement suggestions.Results:The study results indicated that the total costs in the Department of Acupuncture and Moxibustion were significantly higher than those in the Department of Orthopedics.Among medication costs,the total medication costs in the Department of Orthopedics were higher than those in the Department of Acupuncture and Moxibustion,with costs for Western medicine,proprietary Chinese medicine,and herbal medicine all being higher(p<0.05).Regarding examination costs,consultation fees in the Department of Orthopedics were lower than those in the Department of Acupuncture and Moxibustion,while examination costs were higher(p<0.05).In terms of treatment costs,orthopedic treatment and surgical fees were higher than those in the Department of Acupuncture and Moxibustion(p<0.05).For laboratory test costs,orthopedic laboratory fees were significantly higher than those in the Department of Acupuncture and Moxibustion(p<0.05).Among nursing and other expenses,orthopedic blood transfusion,bed fees,and other expenses were higher than those in the Department of Acupuncture and Moxibustion,while nursing fees were lower(p<0.05).Conclusion:Treatment fees in the Department of Acupuncture and Moxibustion are the core and account for a relatively high proportion of the total costs.The benefits generated by the Department of Orthopedics are primarily derived from medication,examination,and laboratory fees,aligning with the characteristics of combining diagnosis,medication,and surgical intervention in orthopedic treatment.Consultation fees,nursing fees,and bed fees in the Department of Acupuncture and Moxibustion are higher than those in the Department of Orthopedics,indicating a longer treatment cycle in acupuncture,which warrants clinical attention.展开更多
Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall per...Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.展开更多
With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements ...With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements imposed by the new medical reform on human resource allocation in public hospitals,examines existing issues such as an unbalanced personnel structure,unscientific job design,and an inadequate talent mobility mechanism,and proposes corresponding optimization strategies.These strategies include improving the recruitment and selection process,scientifically planning job structures,and establishing a flexible talent mobility mechanism.The goal is to enhance the quality of medical services,improve hospital operational efficiency,and promote the sustainable development of public hospitals.展开更多
China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Easter...China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.展开更多
During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented chall...During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.展开更多
Public hospitals are the most important components of health systems and account for a large proportion of health resources in China. However, few researches on the efficiency assessment of public hospitals have been ...Public hospitals are the most important components of health systems and account for a large proportion of health resources in China. However, few researches on the efficiency assessment of public hospitals have been conducted in Tianjin, China. On the basis of the data of annual health service report in 2013 from the Ministry of Health, we measured the relative efficiency of the tertiary general public hospitals in Tianjin and estimated the magnitudes of output increase and/or input reduction by using data envelopment analysis to improve hospital efficiency. The main findings of this study indicate that more than half of the sample hospitals operate at a technical and scale efficiency, and the prevalent scale inefficiency is increasing returns to scale. Moreover, it is a prominent issue that health resource constraint and resource waste coexist. Health policy-makers and hospital administrators would need to address these problems by taking comprehensive measures such as optimizing the allocation of health resources, implementing hierarchical diagnosis and treatment, as well as innovating medical-service operating mechanism of public hospital to improve the people's wellbeing.展开更多
The health care sector is the most difficult one to manage and control. Special units in this field are public hospitals which are required to prepare a lot of reports to various institutions, including the ownership ...The health care sector is the most difficult one to manage and control. Special units in this field are public hospitals which are required to prepare a lot of reports to various institutions, including the ownership body. The paper focuses on two issues. The first is the presence of behavioral factors in the reporting of public hospitals in Poland to the ownership bodies. This article aims to indicate the thematic areas of specific reports, most affected by behavioral factors and explain the causes and consequences of their occurrence. The second issue is the analysis of the legal status of obligatory reporting of public hospitals. Participants of the conducted research, due to their specific ownership and political and social position, were public hospitals in Poland. The paper uses the research methods of the meta-analysis of the literature, legal acts in Poland and empirical materials, and also the methods of synthesis, observation, and deduction. Data analysis focused on specific sample of reports issued by Polish public hospitals for their ownership body. The research shows that hospitals draw up a tremendous number of often thematically overlapping and redundant reports addressed to different institutions in different time periods. It is a consequence of legal regulations failing to streamline the reporting of the health care sector institutions, in particular public hospitals. The paper points to the large number of legal instruments that contain imprecise requirements resulting from the complex and obscure forms of control of public funds allocation in this sector. There are many behavioral factors that shape some fields of public hospitals＇ reports, for example, interpersonal relationships, egoism, private financial interests, strengthening of the employment status and professional position, and professional competences. There is considerable freedom in the reporting process fulfilled by public hospitals in Poland for their ownership body. It causes strong consequences, like poor-quality data, duplication of information, and its chaos, as well as high costs of obtaining information. Reporting system of financial and non-financial data of public hospitals in Poland is dysfunctional.展开更多
Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperat...Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperation but also stakeholder involvement. A key component of both these policies is the development of good governance principles in all health care agencies and organizations. A neglected dimension in these debates has been the role of the public hospital which remains a vital and expensive dimension of service provision. In a case study of a public hospital in South Africa, this paper charts the readiness of its management principles and activities to provide quality health care linked to population health and to contribute to the non-medical determinant of health. Using Taylor’s principles of good governance, we conclude that there is a mixture of good and not so good governance activity. The paper concludes by examining the external constraints on the public hospital and by providing suggestions for future activities.展开更多
Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (...Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.展开更多
At the present stage, the public hospital has not stopped the pace of reform , although they are starting from the interests of the people, but also made some achievements, but there are still many problems in the pro...At the present stage, the public hospital has not stopped the pace of reform , although they are starting from the interests of the people, but also made some achievements, but there are still many problems in the process of reform. Especially many scholars including the national government for public hospitals return to public welfare, bat in actual operation there are many are contrary to the nature of public welfare, there is an inherent logic contradiction between theory and practice, the public hospital is difficult to return to public welfare. The path of public welfare regression of public hospitals by the layers of obstacles, this article through the literature study, on-the-spot investigation, interview method to study the fundamental crux of the problem, combined with other path synthesis Research has laid a good theoretical foundation for public hospitals to return to public welfare as soon as possible展开更多
The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to Se...The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC.展开更多
Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level publ...Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level public hospital namely Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January to December 2021. Data were collected through face-to-face interview using a structured questionnaire containing demographic details and experiences faced by the nurses in service provision during COVID-19. Data was analysed by using SPSS (Statistical Package for Social Science) software version 23. Results: The findings revealed that the mean age of the respondents was 32.35 ± 7.248 years, the minimum age was 23 years and maximum age was 58 years. About half of the respondents 52.1% were in 21 - 30 years. The majorities 89% were female. More than half of the respondents 72.6% were Muslim and 63.83% of respondents have completed Diploma in nursing. About 32.2% respondents were living with senior citizen, 33% respondents were infected by COVID-19, 24.23% respondent mentioned nurse-Patient ratio in general ward was 1:7 and 71.08% mentioned nurse-patient ratio in I.C.U/C.C.U. was 1:3 (December 2021). PPE were available among 88.0% respondents and N95 mask were available among 84.0% respondent. About 34.8% respondents got COVID-19 guideline training and 32.4% got donning and doffing training. More than half of the respondents 76% stated that equipment is adequate, 56.38% respondents mention that insufficient of nurses and 53.7% were mentioned insufficient of subordinate staff. About 22.6% respondents faced social stigma and majorities 96.5% respondents mentioned they got proper family support. There was a significant association found between Professional educational qualification and satisfaction of current designation (p value = 0.001 Conclusion: The most important findings of this study was lack of training, insufficient of manpower especially nurses and subordinate staff, high nurse-patient ratio and fear about personal and family safety. The findings of the study will be helpful for the authority in planning for future course of action.展开更多
In recent years,the domestic government has issued a series of new medical reform policies to speed up the reform of hospitals.However,there are still many problems in the internal asset management of public hospitals...In recent years,the domestic government has issued a series of new medical reform policies to speed up the reform of hospitals.However,there are still many problems in the internal asset management of public hospitals,such as low asset management efficiency,incorrect asset accounting and lack of asset management system.Taking the new accounting system as an opportunity,strengthening the management of hospital fixed assets and improving the hospital's asset control ability are the necessary conditions for the development of the hospital.This paper discusses the problems in the management of fixed assets in public hospitals and puts forward some effective measures to solve these problems in order to provide help for the healthy development of hospitals.展开更多
With the rapid development of hospital information construction and the wide application of information system, the importance of information system in the overall business operation of the hospital is becoming increa...With the rapid development of hospital information construction and the wide application of information system, the importance of information system in the overall business operation of the hospital is becoming increasingly prominent. Based on the importance of the internal information system of public hospitals in hospital work, this paper analyzes the security risks and operational risks existing in the use of the current hospital information system, explores the importance and development measures of information system audit, and improves the operation quality and service efficiency of the internal information system of hospitals.展开更多
To promote the high-quality development of public hospitals, to implement standardized and refined management of public hospitals and to achieve quality improvement and efficiency enhancement, operation management and...To promote the high-quality development of public hospitals, to implement standardized and refined management of public hospitals and to achieve quality improvement and efficiency enhancement, operation management and internal control management are the keys. In view of the operation management and internal control management of public hospitals, the state has issued relevant policies and regulations, which set up a high-quality development policy framework and method path for the hospitals. This paper selects three perspectives to think and put forward arguments on how to implement the policies according to the public hospitals' own conditions. Firstly, from the perspective of the relationship between operation and internal control, it discusses how to balance the implementation of operation and internal control, and clarifies that both operation and internal control should be carried out simultaneously;The second is to put forward some opinions on how to carry out the operation and internal control of small public hospitals which are facing more difficulties and challenges in the process of high-quality development, pointing out that they should pay attention to practice and effectiveness;The third is to discuss the relationship between financial management and internal control management of operation management, pointing out that financial management is closely related to both but different from each other. Strengthening financial management can help operation and internal control;At the same time, the difference between operation and internal control and finance should be emphasized so as to pay more attention to and carry out operation and internal control more effectively and provide a stronger impetus for the high-quality development of public hospitals.展开更多
After the implementation of the policy of paying by disease type, public hospitals need to completely change the operation and management mode, from scale expansion and development to refined connotation construction....After the implementation of the policy of paying by disease type, public hospitals need to completely change the operation and management mode, from scale expansion and development to refined connotation construction. According to the current situation of implementing payment by disease type in public hospitals and the actual problems encountered in the cost management, this paper provides countermeasures and suggestions for further optimizing the cost control measures, better promoting the healthy development of public hospitals, and comprehensively improving the level of operation and management.展开更多
With the current reform and development of domestic hospital medical and health system and mechanism, public hospitals have entered the stage of deepening development and reform. In the era of reform and development, ...With the current reform and development of domestic hospital medical and health system and mechanism, public hospitals have entered the stage of deepening development and reform. In the era of reform and development, public hospitals should provide high-quality medical services for the public, and can better promote the allocation of resources, so that resources can be reasonably applied, and thus the steady development of hospitals. This article analyzes the current situation of hospitals and how to use cost-benefit analysis to improve the efficiency of operation in hospital economic management.展开更多
In the daily operation of public hospitals, fixed assets are an indispensable part for hospitals to perform various duties and ensure the orderly execution of various administrative work. Generally, the hospital fixed...In the daily operation of public hospitals, fixed assets are an indispensable part for hospitals to perform various duties and ensure the orderly execution of various administrative work. Generally, the hospital fixed assets have high use value, and their allocation and use period are long, which will not only bring long-term economic impact to the hospital, but also easily cause various risks. Improving the management of hospital fixed assets, analyzing the existing problems found in bidding, purchasing, using and disposing, and exploring and giving the optimization strategies can make the allocation of hospital resources more effective and fully guarantee the sustainable development of the hospital in the future. In view of this, this paper gives the optimization strategy, hoping to provide reference for public hospitals to improve their internal control management level.展开更多
As the country vigorously promotes the medical reform, public hospitals urgently need to optimize the cost management mechanism and process, explore the idea of cost control, seek benefits from management, and improve...As the country vigorously promotes the medical reform, public hospitals urgently need to optimize the cost management mechanism and process, explore the idea of cost control, seek benefits from management, and improve the overall operation and management level, so as to promote the hospital to a high-quality sustainable development path.展开更多
Background： China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measur...Background： China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis （DEA） model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development. Methods： We chose 12 country-level hospitals based on geographical distribution and the economic development level inAnhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions. Results： During 2010-2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was 〉1, and the rest are 〈1 between 2010 and 2015. Conclusions： In 2010-2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.展开更多
文摘Objective:This study aims to explore the benefit analysis of the same disease in different departments of public hospitals under the DIP payment method.Methods:This study is a retrospective analysis that selected clinical data from patients who received treatment in the Department of Orthopedics and the Department of Acupuncture and Moxibustion at our hospital from January 1,2023,to December 31,2023.The study compared the costs of medications,examinations,treatments,laboratory tests,nursing and other expenses,and total treatment costs between the two departments.It analyzed the cost structure of the two departments and proposed further improvement suggestions.Results:The study results indicated that the total costs in the Department of Acupuncture and Moxibustion were significantly higher than those in the Department of Orthopedics.Among medication costs,the total medication costs in the Department of Orthopedics were higher than those in the Department of Acupuncture and Moxibustion,with costs for Western medicine,proprietary Chinese medicine,and herbal medicine all being higher(p<0.05).Regarding examination costs,consultation fees in the Department of Orthopedics were lower than those in the Department of Acupuncture and Moxibustion,while examination costs were higher(p<0.05).In terms of treatment costs,orthopedic treatment and surgical fees were higher than those in the Department of Acupuncture and Moxibustion(p<0.05).For laboratory test costs,orthopedic laboratory fees were significantly higher than those in the Department of Acupuncture and Moxibustion(p<0.05).Among nursing and other expenses,orthopedic blood transfusion,bed fees,and other expenses were higher than those in the Department of Acupuncture and Moxibustion,while nursing fees were lower(p<0.05).Conclusion:Treatment fees in the Department of Acupuncture and Moxibustion are the core and account for a relatively high proportion of the total costs.The benefits generated by the Department of Orthopedics are primarily derived from medication,examination,and laboratory fees,aligning with the characteristics of combining diagnosis,medication,and surgical intervention in orthopedic treatment.Consultation fees,nursing fees,and bed fees in the Department of Acupuncture and Moxibustion are higher than those in the Department of Orthopedics,indicating a longer treatment cycle in acupuncture,which warrants clinical attention.
文摘Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.
文摘With the advancement of the new medical reform,public hospitals face numerous challenges and opportunities,making the optimization of human resource allocation a critical priority.This paper analyzes the requirements imposed by the new medical reform on human resource allocation in public hospitals,examines existing issues such as an unbalanced personnel structure,unscientific job design,and an inadequate talent mobility mechanism,and proposes corresponding optimization strategies.These strategies include improving the recruitment and selection process,scientifically planning job structures,and establishing a flexible talent mobility mechanism.The goal is to enhance the quality of medical services,improve hospital operational efficiency,and promote the sustainable development of public hospitals.
基金supported by the National Natural Science Foundation of China(No.71473099)
文摘China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.
文摘During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.
文摘Public hospitals are the most important components of health systems and account for a large proportion of health resources in China. However, few researches on the efficiency assessment of public hospitals have been conducted in Tianjin, China. On the basis of the data of annual health service report in 2013 from the Ministry of Health, we measured the relative efficiency of the tertiary general public hospitals in Tianjin and estimated the magnitudes of output increase and/or input reduction by using data envelopment analysis to improve hospital efficiency. The main findings of this study indicate that more than half of the sample hospitals operate at a technical and scale efficiency, and the prevalent scale inefficiency is increasing returns to scale. Moreover, it is a prominent issue that health resource constraint and resource waste coexist. Health policy-makers and hospital administrators would need to address these problems by taking comprehensive measures such as optimizing the allocation of health resources, implementing hierarchical diagnosis and treatment, as well as innovating medical-service operating mechanism of public hospital to improve the people's wellbeing.
文摘The health care sector is the most difficult one to manage and control. Special units in this field are public hospitals which are required to prepare a lot of reports to various institutions, including the ownership body. The paper focuses on two issues. The first is the presence of behavioral factors in the reporting of public hospitals in Poland to the ownership bodies. This article aims to indicate the thematic areas of specific reports, most affected by behavioral factors and explain the causes and consequences of their occurrence. The second issue is the analysis of the legal status of obligatory reporting of public hospitals. Participants of the conducted research, due to their specific ownership and political and social position, were public hospitals in Poland. The paper uses the research methods of the meta-analysis of the literature, legal acts in Poland and empirical materials, and also the methods of synthesis, observation, and deduction. Data analysis focused on specific sample of reports issued by Polish public hospitals for their ownership body. The research shows that hospitals draw up a tremendous number of often thematically overlapping and redundant reports addressed to different institutions in different time periods. It is a consequence of legal regulations failing to streamline the reporting of the health care sector institutions, in particular public hospitals. The paper points to the large number of legal instruments that contain imprecise requirements resulting from the complex and obscure forms of control of public funds allocation in this sector. There are many behavioral factors that shape some fields of public hospitals＇ reports, for example, interpersonal relationships, egoism, private financial interests, strengthening of the employment status and professional position, and professional competences. There is considerable freedom in the reporting process fulfilled by public hospitals in Poland for their ownership body. It causes strong consequences, like poor-quality data, duplication of information, and its chaos, as well as high costs of obtaining information. Reporting system of financial and non-financial data of public hospitals in Poland is dysfunctional.
文摘Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperation but also stakeholder involvement. A key component of both these policies is the development of good governance principles in all health care agencies and organizations. A neglected dimension in these debates has been the role of the public hospital which remains a vital and expensive dimension of service provision. In a case study of a public hospital in South Africa, this paper charts the readiness of its management principles and activities to provide quality health care linked to population health and to contribute to the non-medical determinant of health. Using Taylor’s principles of good governance, we conclude that there is a mixture of good and not so good governance activity. The paper concludes by examining the external constraints on the public hospital and by providing suggestions for future activities.
文摘Since December 2019, there had been a series of unexplained cases of pneumonia reported in Wuhan, China, and on 12 January 2020, the World Health Organization (WHO) named this new virus as the 2019 novel coronavirus (2019-nCoV). The Novel Coronavirus disease (COVID-19) is an emerging, rapidly changing global health challenge affecting all sectors, including the health sector. This study aimed to investigate nurses’ knowledge, attitudes, and practices regarding the prevention and control of COVID-19. Methods: This cross-sectional study was conducted among nurses in three public health hospitals in Khartoum state. A self-administered questionnaire was used. A total of 14 knowledge questions were adopted. There are 5 questions constructed for attitude. A total of 12 practice questions were used. Mean score of knowledge considers as follows when the mean more than 75% considers as good knowledge while this percent uses as good practice and poor practice respectively to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. Results: Of the 101 nurses approached, a total of 100 nurses responded (99.0% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 1.01 (SD 0.100). The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 1.4176 (SD 1.4176). There was a negative correlation between knowledge and attitude scores (P < -0.014) and between knowledge and practice scores (P < -0.081). Conclusions: The overall levels of knowledge and practice and attitude were good.
文摘At the present stage, the public hospital has not stopped the pace of reform , although they are starting from the interests of the people, but also made some achievements, but there are still many problems in the process of reform. Especially many scholars including the national government for public hospitals return to public welfare, bat in actual operation there are many are contrary to the nature of public welfare, there is an inherent logic contradiction between theory and practice, the public hospital is difficult to return to public welfare. The path of public welfare regression of public hospitals by the layers of obstacles, this article through the literature study, on-the-spot investigation, interview method to study the fundamental crux of the problem, combined with other path synthesis Research has laid a good theoretical foundation for public hospitals to return to public welfare as soon as possible
文摘The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC.
文摘Objectives: To assess the nurses’ experiences in service provision a COVID-19 dedicated tertiary public hospital. Materials and Methods: This descriptive cross-sectional study was conducted in one tertiary level public hospital namely Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January to December 2021. Data were collected through face-to-face interview using a structured questionnaire containing demographic details and experiences faced by the nurses in service provision during COVID-19. Data was analysed by using SPSS (Statistical Package for Social Science) software version 23. Results: The findings revealed that the mean age of the respondents was 32.35 ± 7.248 years, the minimum age was 23 years and maximum age was 58 years. About half of the respondents 52.1% were in 21 - 30 years. The majorities 89% were female. More than half of the respondents 72.6% were Muslim and 63.83% of respondents have completed Diploma in nursing. About 32.2% respondents were living with senior citizen, 33% respondents were infected by COVID-19, 24.23% respondent mentioned nurse-Patient ratio in general ward was 1:7 and 71.08% mentioned nurse-patient ratio in I.C.U/C.C.U. was 1:3 (December 2021). PPE were available among 88.0% respondents and N95 mask were available among 84.0% respondent. About 34.8% respondents got COVID-19 guideline training and 32.4% got donning and doffing training. More than half of the respondents 76% stated that equipment is adequate, 56.38% respondents mention that insufficient of nurses and 53.7% were mentioned insufficient of subordinate staff. About 22.6% respondents faced social stigma and majorities 96.5% respondents mentioned they got proper family support. There was a significant association found between Professional educational qualification and satisfaction of current designation (p value = 0.001 Conclusion: The most important findings of this study was lack of training, insufficient of manpower especially nurses and subordinate staff, high nurse-patient ratio and fear about personal and family safety. The findings of the study will be helpful for the authority in planning for future course of action.
文摘In recent years,the domestic government has issued a series of new medical reform policies to speed up the reform of hospitals.However,there are still many problems in the internal asset management of public hospitals,such as low asset management efficiency,incorrect asset accounting and lack of asset management system.Taking the new accounting system as an opportunity,strengthening the management of hospital fixed assets and improving the hospital's asset control ability are the necessary conditions for the development of the hospital.This paper discusses the problems in the management of fixed assets in public hospitals and puts forward some effective measures to solve these problems in order to provide help for the healthy development of hospitals.
文摘With the rapid development of hospital information construction and the wide application of information system, the importance of information system in the overall business operation of the hospital is becoming increasingly prominent. Based on the importance of the internal information system of public hospitals in hospital work, this paper analyzes the security risks and operational risks existing in the use of the current hospital information system, explores the importance and development measures of information system audit, and improves the operation quality and service efficiency of the internal information system of hospitals.
文摘To promote the high-quality development of public hospitals, to implement standardized and refined management of public hospitals and to achieve quality improvement and efficiency enhancement, operation management and internal control management are the keys. In view of the operation management and internal control management of public hospitals, the state has issued relevant policies and regulations, which set up a high-quality development policy framework and method path for the hospitals. This paper selects three perspectives to think and put forward arguments on how to implement the policies according to the public hospitals' own conditions. Firstly, from the perspective of the relationship between operation and internal control, it discusses how to balance the implementation of operation and internal control, and clarifies that both operation and internal control should be carried out simultaneously;The second is to put forward some opinions on how to carry out the operation and internal control of small public hospitals which are facing more difficulties and challenges in the process of high-quality development, pointing out that they should pay attention to practice and effectiveness;The third is to discuss the relationship between financial management and internal control management of operation management, pointing out that financial management is closely related to both but different from each other. Strengthening financial management can help operation and internal control;At the same time, the difference between operation and internal control and finance should be emphasized so as to pay more attention to and carry out operation and internal control more effectively and provide a stronger impetus for the high-quality development of public hospitals.
文摘After the implementation of the policy of paying by disease type, public hospitals need to completely change the operation and management mode, from scale expansion and development to refined connotation construction. According to the current situation of implementing payment by disease type in public hospitals and the actual problems encountered in the cost management, this paper provides countermeasures and suggestions for further optimizing the cost control measures, better promoting the healthy development of public hospitals, and comprehensively improving the level of operation and management.
文摘With the current reform and development of domestic hospital medical and health system and mechanism, public hospitals have entered the stage of deepening development and reform. In the era of reform and development, public hospitals should provide high-quality medical services for the public, and can better promote the allocation of resources, so that resources can be reasonably applied, and thus the steady development of hospitals. This article analyzes the current situation of hospitals and how to use cost-benefit analysis to improve the efficiency of operation in hospital economic management.
文摘In the daily operation of public hospitals, fixed assets are an indispensable part for hospitals to perform various duties and ensure the orderly execution of various administrative work. Generally, the hospital fixed assets have high use value, and their allocation and use period are long, which will not only bring long-term economic impact to the hospital, but also easily cause various risks. Improving the management of hospital fixed assets, analyzing the existing problems found in bidding, purchasing, using and disposing, and exploring and giving the optimization strategies can make the allocation of hospital resources more effective and fully guarantee the sustainable development of the hospital in the future. In view of this, this paper gives the optimization strategy, hoping to provide reference for public hospitals to improve their internal control management level.
文摘As the country vigorously promotes the medical reform, public hospitals urgently need to optimize the cost management mechanism and process, explore the idea of cost control, seek benefits from management, and improve the overall operation and management level, so as to promote the hospital to a high-quality sustainable development path.
基金This research＇was supported by the grants from the National Natural Science Foundation of China （No. 71473003）, and National Natural Science Foundation of China （71774001）.
文摘Background： China began to implement the national medical and health system and public hospital reforms in 2009 and 2012, respectively. Anhui Province is one of the four pilot provinces, and the medical reform measures received wide attention nationwide. The effectiveness of the above reform needs to get attention. This study aimed to master the efficiency and productivity of county-level public hospitals based on the data envelopment analysis （DEA） model and Malmquist index in Anhui, China, and then provide improvement measures for the future hospital development. Methods： We chose 12 country-level hospitals based on geographical distribution and the economic development level inAnhui Province. Relevant data that were collected in the field and then sorted were provided by the administrative departments of the hospitals. DEA models were used to calculate the dynamic efficiency and Malmquist index factors for the 12 institutions. Results： During 2010-2015, the overall average relative service efficiency of 12 county-level public hospitals was 0.926, and the number of hospitals achieved an effective DEA for each year from 2010 to 2015 was 4, 6, 7, 7, 6, and 8, respectively, as measured using DEA. During this same period, the average overall production efficiency was 0.983, and the total productivity factor had declined. The overall production efficiency of five hospitals was 〉1, and the rest are 〈1 between 2010 and 2015. Conclusions： In 2010-2015, the relative service efficiency of 12 county-level public hospitals in Anhui Province showed a decreasing trend, and the service efficiency of each hospital changed. In the past 6 years, although some hospitals have been effective, the efficiency of the county-level public hospitals in Anhui Province has not improved significantly, and the total factor productivity has not been effectively improved. County-level public hospitals need to combine their own reality to find their own deficiencies.
