Have the Pilot County Hospitals’ Service Capability Been Improved Since the Healthcare Reform? An Analysis of 370 Hospitals in China
Abstract
Background: County public hospital reform is one of the major tasks proposed in Chinese Healthcare Reform., and the evaluation of hospital reform effectiveness is very important and beneficial since it helps the government to understand the current situation of pilot county public hospitals and smoothly start the reform in all county hospitals.
Methods: This study used hospitals data from 2009 to 2012 to evaluate the effectiveness of county public hospital reform through comprehensive service capability. Descriptive analysis method was used, and factor analysis method was used to extract the main factors associated with service capabilities as well as to calculate a composite score. The t-test of two independent-samples methods was used to comparison analyze.
Results: The differences of common factor scores (hospital scale and service capacity, treatment quality, service quality, and services efficiency) between pilot and non-pilot hospitals were not statistically significant (P>0.05). The service capability score in 2012 was better than that in 2009 either in pilot or non-pilot group (P<0.05). The pilot hospitals’ service capability score was better than that in non-pilot groups either in 2010 or 2012 (P<0.05). However, the differences from 2009 to 2012 of service capability score between pilot and non-pilot hospitals were not statistically significant.
Conclusion: The comprehensive service capability of both pilot and non-pilot group all got improvement. However, county public hospital reform did not significantly play a due good role in improving the service capability in pilot group. The reform was helpful to improve the hospital current situation, but it has not completely achieved policy objectives in the sample hospitals of this study.
2. Gai R Y, Zhou C C, Xu L Z, et al (2010). Health re-source allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005. Biosci Trends, 4: 218-224.
3. Developed Statistical Bulletin of National Health and Family Planning in China (2012). National Health and Family Planning Commission of the People's Republic of China.
4. Bloom G, Tang S, Gu X (1995). Financing rural health services in China in the context of eco-nomic reform. J Int Dev, 7:423-441.
5. Bloom G, Xingyuan G (1997). Health sector reform: lessons from China. Soc Sci Med, 45:351-360.
6. Cai K (1990). The future directions of the county and township health institutions. Chinese Rural Health Services Management, 10-13.
7. State Council (2009). Guidelines for deepening health system reform.
8. Shen X. Chuanjun Du (2008). China to pilot medical reform plan this year. Chinese Medical Journal, 121:199.
9. Ying L (2015). The operational technical efficiency evaluation of Ningxia county and township hos-pitals before and after the new medical reform. Shandong University, Jinan.
10. Jiang S, Wu W, Huo H (2015). Study on the efficiency of 41 county-level public hospitals in Guangxi based on DEA model. Chinese Hospital Management, 35:13–15.
11. Shuai J, Weimin W, Li F, et al (2014). Surveying the patients’ satisfaction on pilot county hospitals after the new medical reform. Chinese Health Service Man-agement, 12:905–907.
12. Huimei H (2014). Preliminary assessment of com-prehensive reform of county public hospital in Zhejiang Province. Zhejiang University, Hang-zhou.
13. Zhenfang H (2014). Study and evaluation about the economic operation of the county hospitals in Anhui Province before after the comprehensive reform. Anhui Medical University, Hefei.
14. Suyi L, Chaokun X, Meng B, et al (2013). Healthcare satisfaction among residents in Suqian after healthcare system reform and the influencing fac-tors. Chinese General Practice, 16:84–86.
15. Weiyun L, Yulan J (2014). Survey on the grassroots medical and health service satisfaction of residents in Chengde city after the medical reform. Hebei Medicine, 20:864–867.
16. Fang P, Luo Z, Fang Z (2015). What is the job satis-faction and active participation of medical staff in public hospital reform: a study in Hubei province of China. Hum Resour Health, 13:34.
17. Dongmei H, Wenqiang Y, Qianqian Y et al (2015). Comparison of work well-being among physi-cians in public hospitals before and after the new health reform. Chinese Journal of Hospital Administra-tion, 31:217-220.
18. Gross R (2004). A Consumer Based Tool for Evalu-ating the quality of Health Services in the Israeli Health Care System Following Reform. Health Pol-icy, 68:143-158.
19. Von demKnesebeck, Joksimovic L, Badura B, Siegri J (2002). Evaluation of a community-level health policy. Health Policy, 61:111-122.
20. Liberati A, Apolone G, Lang T, Lorenzo S (1995). A European project assessing the appropriateness of hospital: background, objectives and prelimi-nary results.Int J Qual Health Care, 7:187-199.
21. WHO (1996). Integration of Health Care Delivery, Report of WHO Study Group. World Health Or-gan Tech Rep Ser, 861:1-68.
22. Pai YP, Chary ST (2013). Dimensions of hospital service quality: a critical review: Perspective of pa-tients from global studies. Int J Health Care Qual As-sur, 26:308-40.
23. Camilleri D, O'Callaghan M (1998). Comparing pub-lic and private hospital care service quality. Int J Health Care Qual Assur Inc Leadersh Health Serv, 11(4-5):127-33.
24. Choi KS, Lee H, Kim C, Lee S (2005). The service quality dimensions and patient satisfaction rela-tionships in South Korea: comparisons across gender, age and types of service. Journal of Services Marketing, 19:140-149.
25. Dabholkar PA, Shepherd CD, Thorpe DI (2000). A comprehensive framework for service quality: an investigation of critical conceptual and measure-ment issues through a longitudinal study. J Retailing, 76:139-73.
26. Dagger T, Sweeney JC (2007). Service quality attribute weights: how do novice and longer-term cus-tomers construct service quality perceptions? Jour-nal of Service Research, 10:22-42.
27. Jiang S, Wu W, Fang P (2016). Evaluating the effec-tiveness of public hospital reform from the per-spective of efficiency and quality in Guangxi, Chi-na. SpringerPlus, 5:1922.
28. López-Arellano O, Jarillo-Soto EC (2017). A health system's neoliberal reform: evidence from the Mexican case. Cad Saúde Pública, 33:e00087416.
29. Bo Burström, Kristina Burström, Gunnar Nilsson, et al (2017). Equity aspects of the Primary Health Care Choice Reform in Sweden – a scoping re-view. Int J Equity Health, 16:29.
30. Agyepong IA (1999). Reforming health service deliv-ery at district level in Ghana: the perspective of a district medical officer. Health Policy Plan, 14:59-69.
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Issue | Vol 48 No 3 (2019) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijph.v48i3.891 | |
Keywords | ||
County hospitals Service capability Evaluation Healthcare reform China |
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