How to Promote Financial Management Level of Public Hospital under the New Medical Reform

Following the continuous development of our country's economy,the new medical reform of our country is also gradually speeding up.And potential problems existing in public hospital's financial department are being gradually magnified that has brought new challenge to financial management.The financial staff are studying the problems and trying to solve the problems through their working experiences from long-term practices and on a certain basis.Therefore,in this article,we try to find out the existing problems and to explore efficient solutions to the problems under the background of new medical reform and in the light of the importance of financial management to public hospital's development.The main purpose of this study is to try to solve the existing problems in financial management of public hospital so as to promote perfecting the systems of public medical institutions to get a better development.

Transformation of the Chinese medical and health development： from the perspective of the public hospital reform

The mistakes of ＂Old healthcare reform＂ lead to bad consequences： the contradiction between the reducing government investment and the rising costs of medical treatment, the contradiction between the nature of the public welfare and the marketization of hospitals, and the contradiction between the unlimited demand growth for medical services and the scarcity of qualified medical resources. The causes of the failure of ＂old healthcare reform＂ are the loss of market-oriented reform and the decadence of medical tenet.

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.

The discussion on the impact of medical service charge standard adjustment on public hospital’s income

[目的] 探讨天津市公立医院综合改革实施意见的颁布及实施后对医院医疗总收入情况的影响. [方法]对天津市7 8家医院2015年相关数据进行调价改革测算和对比分析.[结果]医疗总收入总量得到了控 制,收入结构进行了调整,药品收入占总收入比例由48. 97 %下降到43.45%.[结论]改革的实施,提高了医 疗服务价格的含金量,有助于促进医疗技术水平的提升.但还存在着价格调整不均X 、患者费用增长不平衡、 病源流动性等问题.

Analysis of Internal Control Management Problems in Hospital Finance and Accounting

This paper outlines the internal control management of hospital accounting and finance,introducing its concept,importance,and objectives.It then analyzes the problems existing in the internal control management of hospital accounting and finance,including an unsound management system,insufficient system implementation,inadequate risk assessment and control capabilities,poor information communication,weak internal supervision,and uneven personnel quality.The reasons for these problems are also analyzed,including outdated management concepts,irrational organizational structures,imperfect training and incentive mechanisms,low levels of information technology,and changes in the external environment.This paper proposes improvement measures for the internal control management of hospital accounting,including enhancing the management system,strengthening system implementation,improving risk assessment and control capabilities,enhancing the information communication mechanism,strengthening internal supervision,improving personnel quality,advancing information technology,and adapting to changes in the external environment.

Private hospital expansion in China:a global perspective

Objective:To assess the private hospital development in China during 2005-2016 from a global perspective.Methods:We searched the English and Chinese literature in PubMed,CNKI and Google Scholar databases with the keywords including“private hospitals in China”,“hospital ownership”,“public and private hospital”,“private hospital development”.Descriptive statistical analysis was used to assess the trend of the private hospital development in China and worldwide.Both the change of private hospitals in supply capacity and health care delivery were studied in this paper.The number of hospitals,number of hospital beds and the average number of hospital beds per hospital were employed to measure the supply capacity.The visit number,inpatients number,and bed occupancy rate(BOR)were used to measure the healthcare delivery.The data was collected from the China Health Statistical Yearbook and the“Organisation for Economic and Co-operation and Development(OECD)Statistics”website.Results:The private sector rapidly expanded in China’s hospital market in recent years.The number of private hospitals exceeded the public in 2015.There has also been a signi cant rise for the indicators of both the supply capacity(including number of hospitals,number of hospital beds and the average number of hospital beds per hospital)and the health care delivery(inpatients number and BOR)of the private hospitals.However,the growth rates of them were relatively lower than the public.The expansion trend of China’s private sector in the hospital market accorded with most the OECD countries around the world.In 2016,China was above the medium level of the share of the private hospitals’number with the OECD countries,but below the medium for the supply capacity,in terms of the hospital beds.Conclusion:As a result of the economic growth and supporting policy,the private sector has experienced a vast expansion in China’s hospital market in the past decade.The rising gap in average size between private and publicly owned hospitals,and the inconsistent development between the private hospitals’supply capacity and their market share,have become the two main challenges.Meanwhile,the future policy in supporting the private sector should be carefully introduced to advance the whole healthcare delivery system development in China.

新医改背景下医院档案管理工作提质增效路径研究

随着医疗行业的改革发展,医院档案管理工作需适应新的行业环境,创新档案管理模式,提高档案管理效率和服务质量。文章基于医疗改革背景下,分析医疗改革对医院档案管理工作的影响,调查新医改背景下医院档案管理的现状并剖析存在的问题,从增强医院档案管理意识、完善医院档案管理制度、推进医院档案信息化建设、加强医院档案人员培训与考核等方面提出建议措施。

某大型综合公立医院运营管理模式构建与实践探索

提升运营管理精细化水平是推动医院高质量发展的内在要求。某大型综合公立医院创新管理机制,构建全方位系统化运营管理模式,在专题运营分析、精细成本核算、优化绩效考核等方面采取系列举措,关键运营指标持续向好,有效促进了医院运营管理科学化、规范化和精细化。介绍了其运营管理模式和实践探索举措,为公立医院提升运营管理水平提供参考。

DRG支付背景下某公立医院专科建设思考及实施效果分析

近年来,随着医改的持续深化,按疾病诊断相关分组(DRG)支付逐渐成为新医改的焦点。DRG支付制度不仅是医保结付的方式,同时也是公立医院规范医生诊疗行为、衡量医疗服务质量的管理工具,促使医院由粗放管理转向精细管理转型,对公立医院的运营管理理念提出一系列挑战。因此,分析DRG支付方式改革给公立医院带来的影响以及相关运营情况意义重大。笔者选取某公立医院推进DRG支付方式改革以来的22 791例病案资料进行分析,探讨在DRG支付背景下医院运营的应对策略及主要问题,为公立医院更好地落实DRG支付政策及高质量发展转型提供建议。

某公立医院医用耗材SPD管理模式实践探索

目的:建设医用耗材SPD物流管理模式,提升医院医用耗材管理水平。方法:采用传统耗材管理模式与医用耗材SPD管理模式相比较的方法;通过医用耗材SPD物资管理系统与HIS收费系统互通、射频识别技术、智能屋和智能柜等对医院医用耗材进行精细化管理。结果:运用医用耗材SPD管理模式有效减少了医护人员管理耗材工作量,提升了工作效率,降低了耗材库存资金占用量与耗材管理成本,有效降低了耗占比。结论:SPD管理模式可有效提升医用耗材特别是低值耗材精细化管理水平,实现降本增效,促进医院高质量发展。

三级公立医院绩效考核背景下医院运营管理的研究

国家三级公立医院绩效考核开始于2019年,运营效率作为考核的一部分,相关的国家监测指标有9个,包含收支结构和费用控制。绩效考核是医改工作的有力抓手,也是加快现代医院管理制度建立的强劲推手。通过分析某三级甲等口腔专科医院在绩效考核背景下运营效率指标的得分情况,找出原因;并通过加强党建引领,做好医院运营管理体系架构顶层设计,加强医疗质量管理,落实医改相关政策,加强能耗管理,不断提高员工福利待遇,强化公立医院功能定位,提高医疗服务收入占比,绩效分配体现医务人员的劳动技术价值,提高运营管理能力,助推医院高质量发展。

对103家三级公立医院医疗设备配置现状的调查与分析

目的:调查103家三级公立医院医疗设备配置现状,分析比对我国不同区域医院的医疗设备占比,为科学合理地配置医疗设备提供依据。方法:采用文献研究和专家咨询法设计调查问卷,通过“中国医学装备”公众号和“好医工”平台发布电子问卷进行调查,分析医疗设备配置数量、国产占比与医院所在区域及医院床位数的相关性。结果:共回收有效问卷103份,涉及华东、华北、华中、华南、西南、西北和东北的103家三级公立医院,其中华北占18%,华东占37%,华南占19%。华北、华南和华东3个样本区域三级公立医院医疗设备配置的平均台件数为9785台/家、9245台/家和8153台/家,甲乙类设备配置数量较少,与床位数无相关性;华北与华东在床位数、每百张床设备台件数以及每百张床设备金额上差异有统计学意义(t=-2.582、2.939、4.653,P<0.05);生命支持类设备配置数量均与床位数有显著正相关,国产占有率尤其是生命支持类设备的国产占有率有所提高。结论:分析我国公立医院医疗设备配置情况,可为医院更好地适应新版甲乙类大型医用设备目录的调整提供数据支撑,为三级医院在大型医用设备配置和国产化的示范推广提供参考依据,为相关卫生管理部门提供借鉴。

“国考”下中医药特色服务能力提升的实践探索

国家三级公立中医医院绩效考核是检验公立中医医院改革发展成效的重要标尺,是高位推动公立中医医院政策落实的有力抓手,更是落实三级公立中医医院功能定位的“指挥棒”。文章结合江苏省南通市中医院充分发挥国家三级公立中医医院绩效考核“指挥棒”作用,研究分析“国考”下中医药服务能力建设的内涵,通过加强党建引领、增强服务效能、创新服务模式等实践探索与取得成效,以期为引导中医医院强化中医药特色优势、提升中医药服务能力,促进中医医院主动加强和改进科学管理能力,实现坚持中医办院方向功能定位,不断深化医改,助推中医医院高质量可持续发展提供参考。

突发公共卫生事件背景下公立医院医疗物资供应冲突管理

文章基于突发公共卫生事件状态下公立医院医疗物资供应冲突发生的环境、事发经过、情境结果及冲突条件等要素,运用冲突管理有关理论探索冲突的构成要素及其结果、冲突中人员管理的一般性方法及冲突解决途径。在研究中不难发现,强制型管理风格在应对医疗物资全方位供应复杂性工作面前适用性略显不足,知识型员工在保健与激励因素共同负强化下使得人员管理更加如履薄冰,合作型冲突管理能够较为有效地解决冲突窘境。组织中的各类冲突在所难免,冲突的发生与领导管理风格、组织目标一致性、团队成员的激励程度、人际关系的维系与促进等因素息息相关,应关注冲突的管理方法,通过替代性方案建设性地加以解决至关重要。

某大型公立医院医养结合模式实践探索

随着人口老龄化程度的加深以及医疗需求的增加,家庭病房作为一种医养结合服务模式逐渐受到重视,成为一种对医疗资源紧缺的重要补充手段。广东省第二人民医院建设智慧家庭病房,探索实践医养结合“互联网+养老”新模式。本文以广东省第二人民医院建设智慧家庭病房的医养结合实践为对象,探索分析公立医院医养结合“互联网+养老”模式在应用中存在的问题,并提出相应的对策建议。

基于国家公立医院绩效考核的医疗服务能力评价和提升策略研究

目的:以广州市为例,评价三级公立医院医疗服务能力,提出医疗服务能力的提升策略。方法:采用熵权-TOPSIS方法和Kernel密度估计,评估2019-2021年广州市省部属、市属和区属三级公立医院的医疗服务能力。同时,运用Dagum基尼系数分析医疗服务能力的不平等程度。结果:研究显示,广州市三级公立医院在医疗服务能力上存在显著差异。省部属医院整体表现较好,市属医院正在缩小与省部属医院的差距,而区属医院面临较大挑战。基尼系数分析揭示不同级别医院之间以及同一级别内部的医疗服务能力不平等问题。结论:为提升医院服务能力,建议实施差异化策略,明确不同类型医院的功能定位,并关注内涵式发展。加强跨医院合作和知识共享,提高科学管理水平,并加大政策和资金支持,尤其是对区属医院。

基于HRP系统的医用耗材精细化管理模式实践探索

目的在医用耗材零加成、疾病诊断相关分组付费改革的实施背景下,探索医用耗材精细化管理模式,为公立医院高质量发展提供保障。方法以北京市某公立三级综合医院为研究对象,基于医院资源规划(Hospital Resource Planning,HRP)系统物资管理模块信息联通形成的数据,以规范临床用耗行为为导向,探索在医院运营管理委员会、医用耗材管理委员会领导下,以物资管理部门为主导,与医务、护理、医保、绩效等管理部门协同联动,以“精细管理、控制成本、优化结构”的理念为主线,对医用耗材目录、医用耗材申领、医用耗材消耗以及医用耗材监测进行精细化管理的模式。比较2023年2-7月与2021年同期的耗材成本、收入结构,来检验基于HRP系统的精细化管理模式的实践成效。结果经实践,该院医用耗材管理相关人员的精细化管理意识提升;2023年2-7月百元医疗收入消耗卫生材料(不含药品收入)相较2021年同期明显降低,差异有统计学意义(P<0.001),耗材成本控制初见成效;2023年2-7月医院耗占比相较2021年同期明显降低,医疗服务收入占比相较2021年同期明显升高,差异均有统计学意义(均P<0.001),收入结构有所改善。结论基于HRP系统的医用耗材精细化管理模式,可有效控制成本,促进收入结构优化,降低管理风险,可为公立医院耗材控制提供参考。

公立医院医用耗材带量集采管理问题与对策研究

目的在医用耗材带量集采扩面提质的背景下,耗材集采的“一品一策”给公立医院耗材管理工作带来挑战,本研究通过探究广东省某公立三甲医院医用耗材带量集采过程中可能发生的管理问题,设计并实施相应管理对策并衡量其执行效果。方法应用鱼骨图分析法系统分析医用耗材带量集采执行过程中的潜在问题,并于2023年5月—7月在院内采取针对性措施。选取该医院2022年12月—2023年12月冠脉支架、起搏器、管型/端端吻合器以及脊柱产品的集采时序作为研究对象,衡量其干预前后的月度执行率、合同完成量变化,判断干预成效。结果鱼骨图分析结果显示影响集采执行的主要因素有内部制度不完善、人员管理无法满足需要、供货问题、信息系统欠缺等因素。干预后集采月度执行率(t=-4.19,P<0.05)、合同完成量(t=-2.38,P<0.05)均高于干预前,差异具有统计学意义。结论对医用耗材带量集采实施干预管理能有效促进科室带量集采执行效果。在带量集采的环境下,临床以及卫生管理人员需要进一步提升自身专业性,保障耗材集采管理的效率与质量;并深化对政策的理解并落实,完善生产配送环节的监督与惩戒机制,多部门联动落实供应保障;以及提升医院与集采平台信息系统。

A Study of In-Hospital Charitable Aid Resource Categories and Application Dilemmas: An Empirical Investigation Based on R Hospital

To better understand the challenges faced by public hospitals in implementing charitable medical assistance,this study examines Nanjing R Hospital as a case study.By combining literature review and field research,the current status and fundamental methods of charitable medical assistance at R Hospital are systematically analyzed.The findings indicate that medical social workers play a multifaceted role in the hospital’s charitable assistance efforts.They contribute significantly to building assistance networks and addressing patients’multi-dimensional needs.However,challenges persist in the assistance process,including both external and internal obstacles.This study explores ways to overcome these barriers to enhance the efficient utilization of healthcare resources.Through empirical investigation,the study identifies the types of charitable aid resources available and highlights the practical difficulties in their application within public hospitals.These findings provide a valuable reference for optimizing resource allocation,improving the effectiveness of assistance programs,and fostering institutional collaboration.

公立医院医疗质量智慧化管理体系建设路径探讨

加强全面质量安全管理对提升医疗服务水平、保障患者安全和提高医疗效率具有重要意义。在探讨医疗质量智慧化管理体系建设意义和作用的基础上,梳理了数据整合与共享、数据分析与挖掘、智能决策支持、运营优化与效率提升、信息安全与隐私保护、人才培养与数字素养提升的关键路径,提出从政策引导、多方协作、技术创新多方面共同推进的建议。