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.

Environmental Information Governance Reform in the Era of Big Data--From Information Disclosure to Public Service

The development of environmental information governance includes three phases: providing for oneself,information disclosure,and public service. And then China is in the transition and transformation of environmental information disclosure to the environmental information public service. The core of the transformation is public participation,in the whole procedure of environmental information supply decision making,production,and quality supervision and evaluation,etc. The target path of the environmental information governance reform includes five parts: improvement of public satisfaction,optimizing information disclosure,information quality control,integration of information resources,and multiple supply.

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.

Qualitative analysis of direction of public hospital reforms in China

Reforms in public hospitals are among the most important improvements in China＇s health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.

Research on China＆#39;s Public Hospital Governance： From Perspective of Implementation Issues

INTRODUCTIONHart once proposed in his book ＂corporate governance＂： Some theory and implications that governance issue would emerge if there is any interest conflict between principal and agent with no support of a complete contract in a principal-agent relation. Governance theory developed from the governance issue believes that an effective institutional arrangement could avoid or decrease the occurrence of these issues and force the agent to maxilnize his principal＇s interest.

公立医院行风建设指数定量评价体系构建研究

目的:从医院管理视角引入指数定量评价体系,用形象、具体且高度凝练的指标和评价要点来描述公立医院的行风建设工作。方法:立足当前公立医院行风建设管理中重点督查的关键领域,围绕落实主体责任、完善制度建设等5个维度,设计定量与定性相结合的行风建设指数评价模式。结果:构建了适用于公立医院临床科室的数字化行风建设指数评价机制,划定评价周期并实行动态管理,实现对行风建设发展问题的精准定位和对行风监督工作具体实施情况的有效全面评估。结论:本研究客观评价医德医风水平和医院行风建设管理现状,有助于综合理解和客观评估复杂的管理行为,为未来数字医院的横向管理与纵向规划提供了有效的战略改进支撑,有助于推动现代化医院行风治理的标准化、精细化和信息化发展。

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。

基于DEMATEL模型的三级公立医院运营效率影响因素分析及对策研究

目的 分析影响医院运营效率的主要因素并提出意见建议,为医院管理部门提升医院运营效能提供参考依据。方法 利用决策试验和评价试验法(dematel)模型分析影响因素之间的相互作用关系。结果 员工工作负荷、人员结构比例、岗位责任、绩效考核方式等12个要素是影响三级公立医院运营效率的关键影响因素。结论 三级公立医院的高效运转是多种因素共同作用产生的结果,提高运营效率要从合理配置人力资源,完善绩效考核模式,优化医疗流程布局,创新发展运营模式等方面入手。

新时代公立医院全面从严治团工作路径研究

目的:调研公立医院团组织自身建设情况,探索新时代公立医院全面从严治团的工作路径。方法:采用问卷调查法,对北京市19所公立医院的1 435名团员和青年进行问卷调查。结果:团组织“第一议题”学习机制已基本落实到位,多数医院已成立青年理论学习小组并开展学习,但77.36%的团员和青年每周自主开展的理论学习时长<2小时;团委班子职数设置和书记、副书记配备基本规范,团支部设置大多数与党支部、科室设置有对应关系,团员和青年对团组织评价高,但只有15.79%的医院设置了除团委书记外的专职团干部;团组织能够对团员和青年经常开展纪法教育和提醒,但38.73%的团干部或团员没有接受过《中国共产主义青年团纪律处分条例(试行)》培训,团干部接受过培训的比例高于普通团员(P<0.001)。结论:要创新思想引领的形式和载体,增强团员和青年政治理论学习的积极性;配齐配强配优专职团务人员,增强团干部能力素质和工作本领;健全完善纪律教育机制,增强团员和青年遵纪守法的意识和能力。

“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。

深圳市公立中医医院医疗服务价格改革历程与思考

通过梳理深圳市公立中医医院医疗服务价格改革历程,分析优势与难点,提出动态调整中医药服务价格,定价应体现中医劳务价值和技术价值,完善医疗服务价格目录,建立中医医疗技术评定指标体系等建议,以助推中医药综合改革,优化深圳中医医疗服务价格改革模式。

公共产品视阈下的中国—拉美全球贸易治理合作

在当前国际格局发生重大变动、全球贸易治理规则遭到破坏的背景下,中国同拉丁美洲和加勒比地区国家在全球贸易治理中的合作体现出南南合作的韧性以及发展中国家团结一致参与公共产品供给的贸易治理观。中国和拉美国家在双边贸易规模不断扩大的现实支撑下,积极开展自由贸易谈判,充分利用服务贸易、产能合作、数字贸易等新模式维持合作基础,共同推进互利共赢的多边议程。面对新一轮的保护主义和经济民族主义压力,中国和拉美国家应摒弃带倾向性的多边合作,强化发展中国家身份认同,维护多边规则,促进自由贸易制度这一公共产品的有效供给。

基于RBRVS和DRG的某公立医院绩效薪酬制度改革路径解析

对某公立医院实施以资源消耗为基础的相对价值比率(RBRVS)和诊断相关分组(DRG)为基础的绩效薪酬制度改革路径进行解析,从改革实施的背景、评价工具选择、实施过程的难点和关键节点、实施后的成果和成效等方面进行详细和深度阐述,指出广泛的基层调研、有力的组织体系、细致的数据治理、自动化的软件建设、合适的方案设计、渐进的改革过程、充分的绩效沟通是案例医院顺利实施改革的路径,改革调动激发了医务人员的积极性,提升了医疗服务质量和效率,促进了医院运营和学科结构的优化,推动了医院高质量发展。

公立医院医疗腐败问题治理路径与防控策略研究

公立医院医疗腐败治理对于推进公立医院改革,加速公立医院高质量发展进程,实现健康中国目标具有重要意义。文章从定量分析案件的角度出发,结合中国裁判文书网医疗腐败案件数据和工作具体实践分析当前公立医院腐败问题现状,深入剖析医疗腐败治理存在的困境,如医疗腐败隐蔽性较强,查处极为困难;利益冲突导致“经济人”代理活动频发道德风险;公立医院内部监督制约机制不够有力等。在此基础上,提出创新公立医院反腐败手段,加强反腐深度;优化绩效薪酬分配体系,强化自我约束;健全公立医院内部制约监督机制,扎实推进惩防体系建设等建议。

药品集采中政府与公立医院间的博弈研究

目的:探究公立医疗机构完成集采任务的动力,分析影响集采工作效果的因素,为政府实施监管及相关决策提供参考。方法:分析14家三级公立医院前五批国家组织集采药品采购情况,基于博弈论的角度,通过构建政府与医院的博弈模型,求出其纳什均衡解。结果:在医院落实集采政策方面,存在政府监管力度不强、公立医院药品报量逐批下降、参与积极性不高等问题。结论:建议优化政府监管机制,加大日常监管力度,完善激励与约束制度,提高医疗机构纯收益等。

DRG支付方式改革下大型公立医院临床路径实施策略分析

临床路径与疾病诊断相关分组(DRG)具有极大的相似性,对规范诊疗行为、控制医疗费用具有重要作用。在分析DRG支付方式改革与临床路径关系的基础上,以湖北省武汉市某公立医院为例,从管理体系、适宜病种、医嘱设置、信息系统、培训考核5个方面探究DRG支付方式改革下大型公立医院临床路径实施策略。

公立医院科室绩效方案改革对DIP患者住院费用影响——基于中断时间序列分析

目的 探讨医保按病种分值付费(Diagnosis-Intervention Packet,DIP)背景下公立医院科室绩效方案改革对DIP患者住院费用的影响,为优化公立医院科室绩效管理制度、降低DIP患者住院费用提供参考。方法 收集广东省某县级人民医院2020年7月—2023年7月DIP患者的住院费用数据,采用中断时间序列分析法描述例均住院费用变化趋势,分析该院科室绩效方案改革对DIP患者住院费用的影响。结果 医院科室绩效方案改革后,DIP患者总费用下降1 071.93元,并且每月继续下降116.39元。同时,科室绩效方案改革主要对居民医保DIP患者发挥作用,对职工医保DIP患者没有明显影响。结论 公立医院科室绩效方案改革明显降低了DIP患者的总费用及其分项费用,但是对不同险种DIP患者的影响不同。应进一步完善公立医院科室绩效管理机制,建立与医疗效能、医疗质量等相关的多维度绩效考核指标体系,因地制宜推动公立医院科室绩效方案改革,促进公立医院高质量发展。

中国共产党领导下公立医院发展的百年历程与经验

在党的领导下,我国公立医院发生了翻天覆地的变化,特别是党的十八大以来,以习近平同志为核心的党中央高度重视公立医院改革发展,将其作为事关人民群众健康福祉的重大民生工程,纳入全面深化改革的重要内容进行统筹谋划。在公立医院百年发展历程中,中国共产党审时夺势,结合时代背景和历史条件采取一系列方针政策和主要措施,鼓励公立医院在公益性导向下健康发展,为新时期推动公立医院高质量发展提供参考。