上海市某医院民营化个案研究/Case Study of One Private Hospital Reorganization in Shanghai
关键词：民营医院 改制 个案研究
Case Study of One Private Hospital Reorganization in Shanghai
Some hospitals have begun exploration and practice on hospital system reform in Shanghai. Especially reforms among private hospitals have come to the front. Quyang hospital is one of the hospitals which take the lead in carrying out system reform and it is also the largest private nonprofit hospital in Shanghai. With the support of Health Bureau of Hongkou district, Shanghai Guotai hospital investment and management Co. Ltd bought Quyang hospital on March18, 2003. Thus the original state-owned hospital became a private nonprofit one and took the lead in state-owned hospitals’ privatizing process in Shanghai.
Undoubtedly, after the privatizing, inner reforms in hospitals will be implemented completely and thoroughly. Hospital reorganization and its consequent inner reforms are bound to bring tremendous impact on various aspects, such as hospitals’ benefit, efficiency, employment, culture, future, even community residents, society and government. Hence, society and government have paid much attention to Quyang hospital after hospital reorganization. What inner reforms will the hospital carry out and how to perform it? What changes will system reform bring to the hospital? Will the hospital operate obey the laws and regulations? What measures will private capital take to change the current situation of hospital? Will the health service quality and attitude be improved? Whether will fake pills or poor quality pills emerge or not? Will medical expenditure increase rapidly? Will the community residents within service radius get better health services? How will health service users responseveness to reorganized hospital? What are the main factors that affect the performance of reorganized hospital? And so on. To solve these questions, objective, tracking, continuous and comparing evaluation are needed. Such an evaluation will be able to provide both guidance to hospital’s management and evidence for government to make health policies.
Through literatures review, informant interviews, focus group discussion, willingness investigation and hospital information collecting, the researcher makes analysis for hospitals’ inner reform, auditing and accounting, inner control mechanism, operation and income, medical expenses and other existing problems. The researcher reveals that the hospital reorganization has brought inner reforms and change on efficiency. The researcher also analyzes the problems of hospital reorganization and put forward clues and suggestion for further development of state-owned hospitals and private hospitals.
Following are research results:
1. Hospital system reform provide a good environment to deepen hospital inner reforms.
After hospital reorganization, Quyang hospital has introduced some advanced ideology and methods of enterprise management and hospital management both home and abroad. These reforms have been carried out to make the hospital resemble enterprise. All these reforms are very difficult for a state-owned hospital. These reforms can be advanced smoothly only after a successful system reform in hospital. Hospitals’ system has become one crucial factor that determine whether reform on health service system can be advanced smoothly. Modern hospital management system is to be established to change the current situation.
2. To establish a reasonable scientific auditing and accounting method and reinforce inner control mechanism is the core of hospital management.
To put the idea “economic responsibility” into practice and get employees more active and initiative, the hospital has implemented evaluation on employees’ performance and their output, made regulations to award and punish employees. In this way, employees’ income is directly linked with their economic output, and the more the output is, the more the income is. On the other side, poor performance or loss-cause performance brings punishment. These measures have become inner motive to carry out “economic responsibility”.
3. Hospital reorganization improve hospital inner performance efficiency.
After hospital reorganization, Quyang hospital has improved its efficiency obviously. It is embodied in many ways: there has been pronounced increase of patients discharge from hospital and total income; income structure has been optimized; medical expenditure has been controlled effectively.
4. Serious problems have emerged with hospital reorganization
Employee issues has always been a sensitive and fragile issue and one that relate with stability. If this issue is not addressed properly, the hospital development will be affected. And even worse, it has impact on the relationship between hospital and government thus influence hospital’s external environment. So hospitals have to create some positions for less capable employees with extra cost.
Key words: private hospital , hospital reorganization, case study