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Practice and exploration of the health reform in Wuhu city

Chinese Journal of Hospital Administration.2013;29(10):721-723. doi:10.3760/cma.j.issn.1000-6672.2013.10.001

Wuhu City has been exploring,since 2007,an innovative health and medical system featuring both the reform of public hospitals and that of the primary care system.This reform aims at strengthening the public health service system,improving the basic medical service system,speeding up the construction of the medical security system,and improving the drug supply system.It is characteristic of a core,two wings,and four-wheel drive,which tells the essence of Wuhu' s reform practices and outcomes.

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Performance-based compensation management system at a public hospital in Wuhu

Sizhong HE ; Lixia SUN ; Huaihong WANG ; Annan HE ; Qi LI

Chinese Journal of Hospital Administration.2013;29(10):724-726. doi:10.3760/cma.j.issn.1000-6672.2013.10.002

Reasonable and effective compensation and incentive mechanism is key to maintaining and stimulating incentives of the staff.By means of defining the main problems and defects in the current hospital compensation system in China,performance management is used as the cornerstone for designing the public hospital compensation and incentive mechanism.Resource-based relative value scale(RBRVS) assessment system is called into play to build a compensation management system,which features workload as the basis,technical competency and risk assessment as the reference and balance scorecard as the means.This can build a fair,scientific and reasonable salary distribution system and performance evaluation system,which maximize incentives of the compensation system,and in the end maximize the economic and social benefits of the hospital.

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Insights of a comprehensive target and performance evaluation for public hospitals in Wuhu

Jing RUI ; Xianming KE ; Shougui WANG ; Lixiang DAI ; He XING

Chinese Journal of Hospital Administration.2013;29(10):727-728. doi:10.3760/cma.j.issn.1000-6672.2013.10.003

This paper presented the practice of performance evaluation at public hospitals in Wuhu.The performance evaluation system at public hospitals should emphasize public benefits,present a true picture of work and management performance,and help build the incentive and constraint mechanism.In addition,it should encourage public hospitals to strengthen management,improve quality of care and control health care costs.The system is designed for providing a safe,effective,convenient and inexpensive medical and health services for the people.

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Practice and suggestions for the reform of drug and medical service separation reform and drug zero-profit policy in Wuhu

Ying FENG

Chinese Journal of Hospital Administration.2013;29(10):729-732. doi:10.3760/cma.j.issn.1000-6672.2013.10.004

The drug and medical consumables management center in Wuhu features the operational mechanism separating the decision-making power of drug purchasing,the executive power and the supervision power.This practice terminates the interest chain previously found between medicine suppliers with hospitals,pharmacies and doctors,creating the Wuhu Model of drug and medical service separation at public hospitals.The drug zero-profit policy reshapes the drug supply system and the existing compensation mechanism of public hospitals,further defining the Wuhu Model.This model is paving the way for the same reform to be carried out nationwide.

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Detachment and return of pharmacies of public hospitals in Wuhu amid the drug and medical service separation reform and the outcomes

Ying FENG

Chinese Journal of Hospital Administration.2013;29(10):733-737. doi:10.3760/cma.j.issn.1000-6672.2013.10.005

The separation of drug and medical service is key to alleviating the social problem of high medical expenses,and the top thing to do is to cut off the profit link found in the drugs purchase and sales interests chain.Pharmacies of the hospital are found to play a crucial role in this chain,as they not only take part in the decision-making of drug purchase but also directly purchase and dispense drugs.Wuhu has established the Medicine and Medical Consumables Management Center,which directly regulates the pharmacies and detach them from this chain,weakening their rent-seeking power.Practices of this reform found the pharmacies no longer playing a dominant role in drug purchase/dispensation on one hand,and yet less incentives of the pharmacies due to management by the Center on the other,resulting in poorer pharmaceutical management of the hospital as a result.In this consideration,pharmacies have experienced a detachment and return process from their hospital in the reform of drug and medical service separation in Wuhu.Experiences prove the correct way out is to guide the pharmacies to upgrade from logistics in drug supply to innovated services,thus better serving hospital management.

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Discussions on the medical expenses of colorectal cancer based on clinical pathway

Huixun JIA ; Jing XIE ; Yu WU ; Jing YUAN ; Ji ZHU ; Xiaomao GUO

Chinese Journal of Hospital Administration.2013;29(10):745-749. doi:10.3760/cma.j.issn.1000-6672.2013.10.009

Objective To explore the main factors affecting medical expenses of patients with colorectal cancer(CRC)and reduce such expenses by optimizing the clinical pathway of CRC according to the influencing factors.Methods Data of 467 discharged and medical insured CRC patients at Shanghai Cancer Center,Fudan University,were collected from 2009 to 2010.A multiple linear regression model was applied to analyze the influencing factors of medical expenses.The clinical pathway of CRC was optimized,and medical expenses before and after optimization were compared.Results Our data found days of stay and complications had impact on the medical expenses.Also,medical expenses were decreased accordingly with optimization of clinical pathway of CRC.Conclusion This study provides evidence for decision-making on single disease payment and medical insurance compensation on CRC.It is also meaningful to reduce the economic burden of patients with CRC.

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Two methods applied to comprehensive evaluation of hospital operation management

Wei JIANG ; Aiping LIU

Chinese Journal of Hospital Administration.2013;29(10):753-759. doi:10.3760/cma.j.issn.1000-6672.2013.10.011

Objective Using principal components analysis and weighted TOPSIS method to make objective and accurate evaluation of hospital operation management quality.This aims at proving whether such methods are scientific and feasible for comprehensive evaluation for the quality of hospital operation management and providing the basis for hospital decision making.Methods 15 typical Hospital Performance Indicators were chosen from a cancer hospital during 2008-2012,which were subject to TOPSIS method and principal components analysis,weighted TOPSIS method for comprehensive evaluation.Results The results with principal components analysis and weighted TOPSIS method conform to the actual hospital conditions and prove the rising quality of operation management of the hospital.That is,the closer the date,the higher the ranking.Conclusion Principal components analysis and weighted TOPSIS method are proven flexible,practical,scientific and reliable and suitable for popularization and application in the quality evaluation of hospital operation management.

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Mechanism of adverse drug reaction monitoring and reporting at primary level in Yueqing

Jinghui ZHU ; Guilin LIU ; Xianke ZHU ; Qiaoyan ZHU

Chinese Journal of Hospital Administration.2013;29(10):775-779. doi:10.3760/cma.j.issn.1000-6672.2013.10.018

Compared to the mature monitoring and reporting system of ADRs in developed countries such as the USA and EU,medical institutions in China have played too much a role.Instead,local primary monitoring and reporting system of ADRs should expand their scope of monitoring and reporting,as drug makers,chain drugstores and retailers should develop an effective ADR monitor/report system as well.At present,such a primary system is plagued by insufficient budget and staff,imbalanced urban/rural layout and defective statements.Recommended measures include enhanced surveillance for drug makers,chain drugstores and retailers,for higher reporting ratio of ADRs at primary level; greater publicity and better monitoring and penalty mechanism; better platform for various organizations.

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Building and application of the public welfare evaluation index system for public hospitals

Jixia XIONG ; Min ZHOU

Chinese Journal of Hospital Administration.2013;29(11):816-819. doi:10.3760/cma.j.issn.1000-6672.2013.11.006

Building a systematic public welfare evaluation index system for public hospitals is key to scientific evaluation of the public welfare positioning of public hospitals and enhancing their public benefit orientation,along with references for government decision making on macro health policies.The indexes were screened and pinpointed in two rounds of Delphi expert consultations,and index weights were determined with the variation coefficient method,initially building a public welfare performance evaluation index system for such hospitals,including eight class-1 indexes and 20 class-2 indexes.Outcomes of the system prove that the public welfare performance indexes of the two hospitals evaluated rise year by year from 2008 to 2010.

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Incentive compatibility of medical workers as the inevitable choice for health reform to succeed

Qiang FU

Chinese Journal of Hospital Administration.2013;29(11):840-843. doi:10.3760/cma.j.issn.1000-6672.2013.11.012

Adherence to public welfare and mobilizing incentives are key to promoting the health reform,and making it a success as well.It is imperative to comprehensively and correctly comprehend the importance of mobilizing medical workers in ensuring the reform a success,based on the present practice of the health reform and by views of philosophy,economics,and management.These principles should be followed in the design and perfection of the reform mechanism.

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