公立医院资源浪费及解决方法

公立医院的资源浪费及解决方法

Waste of medical resources in public hospitals

causes and solutions

1. Background

Hospital and department overview: Yunnan Provincial Tumor Hospital, Yunnan Province set of medical, research, teaching, and prevention in one of the Provincial Tumor Hospital, Yunnan Province Cancer Prevention Research, personnel training and the center of the tumor academic exchanges. Hospital in 1992 officially clinic existing medical space of approximately 100,000 square meters, 1,500 sheets open beds, has 23 clinical departments, 11 medical technology departments. Founded in June 1994, the Department of Medical Oncology Yunnan cancer chemotherapy clinical research center affiliated cancer chemotherapy specialist. Sections of the existing medical staff of 25 people, including physicians 9 (Branch Officer 1, 8 all physicians), nurse 16, 46 open beds. Only 10% of the hospital's financial portion of the payment of wages and salaries and social insurance by government funds, and the remaining 90% of income generation by all staff.

2. A hospital economic performance appraisal Profile

Hospitals to implement hospital, department two management systems, scientific director responsibility system, so the management of human resources department, finance department director rights are vested in the hands of one person, only the department director has the authority to decide whether to appoint new staff and additional equipment. Departments to implement full cost-accounting, performance pay for all employees’commission in accordance with the types of income, such as: treatment costs (physician checkups, care, physiotherapy fees) commission of 32%, inspection fees (laboratory tests, ultrasound, CT and other equipment checks charges) commission of 10% and so on. And every penny of expenditure should be deducted from revenue department, and even brought

a clothes from the hospital should be deducted from the pay for performance (but more expensive than buying from the market expensive); sections introduce personnel, equipment costs have to be deducted from income, the cost allocated to each employee, but both at state-owned asset management. This led to strict cost control, director, trying to reduce spending in order to avoid reducing the income of existing staff. Despite nearly five years since my department where the number of patients admitted and key performance indicators (efficiency wages) than before, more than doubled, but the department did not introduce new physicians, all clinicians often overload, overtime work. Hospital encourages employees to generate income, the monthly economic performance appraisal, according to balance of payments surplus allocation of performance pay.

Department for the distribution of pay for performance indicators as the department is mainly based on whether management positions, seniority (in the hospital and department of years of service), job level, the performance and time to score, based on numerical scores assigned performance. This resulted in leadership and high qualification and high titles, the more income pay for performance, but also the level of managers and administrators differential is large, income polarization, take a lot of front-line clinical staff working the lowest income.

3. Waste of medical resources is widespread

February 2013 "Guangming Daily" published "shocking waste of medical resources," the article caused widespread hot. The article pointed out that according to an estimate, China waste of medical resources accounted for 30% of total health care costs over affected areas up to 40% -50%. More experts pointed out that the waste of medical resources has become detrimental to the national health care industry, "cancer." While public hospitals complain lack of government investment, while they are wasting. In order to curb the behavior of various waste of medical resources, although the relevant health authorities such as the restrictions formulated drugs accounted for, according to DRGs; provides for Medicare patients with an average length of stay and average cost savings of medical resources such as hard and fast rules, but the effect of controlling medical costs poor, health care costs continue to grow rapidly. Waste of medical resources manifested in some doctors indiscriminate opening checklist prescription, excessive use of unnecessary surgery, the