海南省二、三级综合医院运营状况调查分析

The Investigation and Analysis of Operating Status in Hainan Province Second and Third Level General Hospitals

目的:了解海南省二、三级综合医院经营和管理方面的基本情况,探讨在当前市场经济环境下公立医院在体制、机制和管理模式上所存在的问题,为卫生行政部门进一步开展医疗改革提供有益的数据和建议。方法:采用横断面调查和问卷调查相结合的方式,对数据进行对比分析和趋势分析。结果:医院医务人员职称"倒金字塔"结构日趋明显;出院病人数呈增加趋势,但全省平均病床使用率普遍不高,二级医院尤为明显;全省平均诊疗费用、平均住院费用和药品比例三大指标近2年都增长较快;医疗纠纷日趋严重。结论:改革开放以来,海南省医疗卫生事业取得了较快发展,医疗环境有了较大改善,医疗服务水平有了较大提高。但调查结果也揭示了海南省医疗机构所存在的不少深层次问题:医疗人才结构不合理、高端人才较为缺乏、医疗资源分配不均衡且浪费现象严重、医疗费用增加导致医患关系紧张和医院经营效率普遍较低等。

Objectives To understand the operating and management status in Hainan second and third level general hospitals, to discuss the problems of present system and management mode occurred in public hospitals which have been operating under the market-economy circumstances, and to provide the beneficial data and suggestions of conducting further health care reform to health administration department. Methods The cross-sectional survey and questionnaires were adopted to the investigation. Comparative and tendency analysis were used for data analysis. Results The structure of professional titles in medical staff was gradually showing an obpyramidal shape. The number of patients leaving hospitals was a growing tendency, whereas the provincial rate of utilization of hospital beds was generally low, especially in the second level hospitals. Rapid growing tendencies were showed in some index such as the average cost of diagnosis and treatment, the average cost of hospitalization and the proportion of medication in Hainan. The medical tangles were becoming worse. Conclusions Since the reform and opening-up process conducted in China, the health care system had been. developed rather fast in Hainan, meanwhile the circumstances and skills of medical service had been improved. However, many deepseated problems were discovered in the investigation, such as the unreasonable structure of medical talents, the shortage of top-notch talent, the serious situation of unequally distribution and waste of medical facilities and resource, the relations between medical staff and patients have become frayed caused by the increasing cost of hospitalization, the generally low operational efficiency in hospitals.