Data Envelopment Analysis on Evaluating the Efficiency of Public Hospitals in Tianjin,China

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.

Behavioral Aspects in Obligatory Reports of Public Hospitals in Poland

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.

The Social Determinants of Health and the Role of the Health Care System: A Case Study of the Significance of Good Governance in Public Hospitals in South Africa

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.

Nurses’ Knowledge, Attitude, and Practice Regarding Personal Protective Equipment for the Prevention of COVID-19 in Public Hospitals Khartoum State Sudan 2022

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.

Bootstrapping Data Envelopment Analysis of Efficiency and Productivity of County Public Hospitals in Eastern, Central, and Western China after the Public Hospital Reform

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.

Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

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.

Analysis of the reasons for the bottleneck of public hospitals＇ return to public welfare

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

Study on the Causes and Countermeasures of Medical Staff Turnover in County Public Hospitals from the Perspective of Developmental Psychology

This study aims to explore the causes of medical staff turnover in county public hospitals from the perspective of developmental psychology and put forward effective countermeasures.Through qualitative research method,a semi-structured in-depth interview was conducted with 23 medical staff in Liannan County Hospital to analyze the current situation and influencing factors of their loss.The study found that difficult working environment,lack of career development opportunities,poor sociocultural adaptation and inconsistency between personal values and organizational goals were the main reasons leading to the turnover of medical staff.In response to these problems,the research puts forward countermeasures and suggestions to improve the working environment,provide career development platform,strengthen social and cultural support,and promote the integration of individual values with organizational goals.The results of this study provide a new perspective for understanding and solving the problem of medical staff turnover in county public hospitals,and provide a reference for relevant policy formulation and hospital management practice.

A Level Field for Private and Public Hospitals

China will encourage more private and foreign investment in hospitals and clinics The State Council on December 3 announced new policies to encourage private and foreign capital in China’s medical sector to meet the

Efficiency and Productivity of County-level Public Hospitals Based on the Data Envelopment Analysis Model and Malmquist Index in Anhui, China

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.

Under the perspective based on ＂collective action system＂ of public hospital reform return to public welfare standard

In recent years, with this social problem of＂Medical treatment is difficult and expensive＂ has not been effectively addressed, ＂Doctor-patient conflicts＂ phenomenon emerge in endlessly, medical costs increase every year, the city public hospital reform continues to be the focus of attention of government and society In this paper, the theory of governance of public ponds of Elinor Ostrom and Mancur Olson＇s theory of logic of collective action as the theoretical basis of this study, Through the entire medical stakeholders together to form a medical community, the formation of multiple, independent management of public hospitals and the whole public health care system.

Measurement of Economic Result in Public Organizations： A Departmental Analysis

The aim of this work is to demonstrate how public university hospital （UH） managers can improve the process of decision-making by using the measurement of economic value added to the society （EVAS） generated by these organizations. Thus, the economic values of the organization and its departments were calculated, according to the theory studied： measurement model of economic result of Slomski （1996）. It was considered the conduction of a case study in a public UH, evaluating its economic performance in a 3-year period. For the interpretation of results, the Data Envelopment Analysis （DEA） which categorized the departments of the hospital studied as efficient or inefficient was used. This study revealed that managers can improve the decision-making process by using the EVAS, since it has been established that this measurement of economic value has sensitivity to identify which of the economic value drivers should be emphasized in the management.

Prevalence of Cesarean Section at Georgetown Public Hospital Corporation, Guyana: An Institution-Based Cross-Sectional Study

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.

Nurses’ Experiences in Service Provision a COVID-19 Dedicated Tertiary Public Hospital

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.

德国医院数量变化分析及对我国的启示

目的描述德国医院数量和构成变化,并进行原因探析,为我国提供启示。方法对近年来德国和我国医院数量和构成变化以及床位数据进行描述性分析,并截取2017年每千人口床位数、平均住院日和病床使用率数据进行对比分析。结果德国医院数量下降,医院体系呈现出私有化和整合趋势;我国医院数量上升,公立医院数量减少,医院规模扩大。结论医院性质、财政投入和医保支付方式改革共同推动德国医院数量和构成变化。我国医院和床位数基本满足人群的健康需要,但仍有提升空间;医改政策相继落地,医疗服务提供者面临机会与挑战;医院管理者应采取多种措施提高自身竞争力。

二级公立医院绩效评估指标体系构建

目的 在获取某区10家二级公立医院绩效数据的基础上,探索建立二级公立医院绩效评估指标体系,通过定量评估医院的绩效表现了解医院运营的优势及不足,引导医院加强精细化管理。方法 通过专家咨询、文献研究等遴选评估指标,以专家咨询确定各维度的关键评估指标及其权重、评估标准等核心因素,采用纵向比较与横向比较,定量分析10家二级公立医院的绩效产出。结果 从社会满意、机构发展角度出发,构建的指标体系包含服务声誉、费用适宜、综合质量、运营效率、发展持续、职工认可6个维度16个指标,赋予指标权重并计算标准化得分,定量评估2017—2018年10家二级公立医院的绩效产出。结论 绩效评估可引导卫生健康局加强对医院运营的管理,引导医院提质增效、实现可持续发展目标。

我国公立医院服务外包现状及问题分析

通过我国公立医院服务外包现状分析,探讨公立医院服务外包存在的问题,对于医院服务外包中存在的主要风险点及内控机制进行分析,提出借鉴企业服务外包的内部控制制度,结合医院实际,建立公立医院服务外包的内部控制机制及优化建议。

公立医院接受捐赠及相关问题探讨

在防治新冠肺炎疫情的过程中,社会各界向公立医院进行捐赠,但由于外部政策和公立医院自身的原因,公立医院对于直接接受社会捐赠积极性不高,从而暴露出我国在公立医院受捐政策上存在不足。目前,公立医院对于捐赠不够重视,没有将其作为筹资的重要途径。究其原因,主要在于基于政策的受捐成本过高、公立医院自身未形成受捐机制、相关法律制度不健全等。建议政府加强供给侧改革,完善相关政策和法律制度,鼓励公立医院开展募捐活动,加强公立医院对捐赠的重视程度,建议设立专门机构和人员负责受捐工作,最终使捐赠成为公立医院事业发展的重要筹资渠道之一。

我国三级公立医院绩效考核指标评分方法分析

基于某市三级公立医院绩效考核实践,指出用加权逼近理想解排序法及全国三级公立医院绩效考核评分办法参考说明中推荐的评分方法进行考核存在的问题与不足,并提出改进和优化评分方法的思路,为构建更加科学公正的绩效考核体系提供新的思路和方法。

宁夏回族自治区县级公立医院住院患者满意度及其影响因素

目的了解宁夏回族自治区实施县级公立医院改革后县级公立医院住院患者的满意度及其影响因素,考察县级公立医院改革的初步成效,以期为医院管理者与卫生行政部门提高医疗服务质量提供决策参考。方法通过电话回访的方式,对4家县人民医院的出院患者进行满意度调查。结果住院患者对医疗服务的总体满意度评分为4.09分(满分为5.00分),对服务态度、就医环境、技术水平、等候时间和医疗费用的满意度评分分别为4.43、4.29、4.13、3.91和3.82分。对住院患者总体满意度的影响由大到小的因素依次是技术水平、医疗费用、服务态度、就医环境和等待时间。住院患者的总体满意度评分较高,但仍有提升空间。总体满意度的主要影响因素为医疗服务相关因素,技术水平和医疗费用是影响住院患者总体满意度的最重要因素,就医流程有待进一步优化。结论建议:合理控制医疗费用;提高医疗技术水平;优化就诊流程,提升就医便利性。