The efficiency of medical services in tertiary public hospitals continues to improve
Public hospitals are the main body of my country's medical service system and the main place for people to see a doctor. Especially large hospitals like tertiary public hospitals are often the first choice for people to seek medical treatment. So, what is the service of tertiary public hospitals? A report recently released by the National Health Commission can tell us the answer.
In 2019, the General Office of the State Council issued the "Opinions on Strengthening the Performance Appraisal of Tertiary Public Hospitals" to launch the performance appraisal of tertiary public hospitals nationwide. This assessment covered 2,398 tertiary public hospitals across the country. After a year of monitoring and analysis, the assessment results were recently announced by the National Health Commission. This assessment report, titled "Circular on the National Monitoring and Analysis of the Performance Appraisal of National Tertiary Public Hospitals in 2018" (hereinafter referred to as the Announcement), although it reflects the situation of "2018", is the most recent and has the most coverage. In a survey conducted by Guangxi, the data still have reference significance.
The "Bulletin" pointed out that the efficiency of medical services in tertiary public hospitals has continued to improve. In 2018, the total number of patients in tertiary public hospitals nationwide was 1.36 billion, an increase of 9.93% over 2016, and the number of discharged patients was 80.47 million, an increase of 13.8% over 2016, both higher than the increase in the number of employees and the number of beds. The average hospital stay was 9.1 days, a decrease of 0.4 days from 2016, the bed utilization rate was 99%, and the time consumption index was decreasing year by year. Compared with 2016, the number of day surgery has increased by nearly 740,000, and the proportion of day surgery in elective surgery has increased by 2.93%.
At the same time, the ability to treat difficult and critical patients has been continuously enhanced. In 2018, the proportion of discharged patients from tertiary public hospitals in the country was 27.4%, minimally invasive surgery accounted for 15.9%, and the proportion of fourth-level surgery 16.4%, both of which increased from 2016. The comprehensive diagnosis and treatment technical capabilities of tertiary public hospitals continued to increase. In the past three years, the medical technical difficulty of tertiary public hospitals (the main indicators reflecting medical technical difficulty are the CMI value, the proportion of fourth-level surgery, etc.) have steadily increased. The CMI value of general hospitals has increased from 1.015 in 2016 to 1.016 in 2018.
The medical quality and safety level that patients are concerned about have also continued to improve. According to the "Bulletin", in 2018, the complication rate of surgical patients in tertiary public hospitals nationwide was 0.48%, and the type I incision infection rate was 0.71%, both of which were lower than in 2016.
In addition, the increase in medical expenses has stabilized. Compared with 2016, in 2018, the average cost of outpatient visits and hospitalization in tertiary public hospitals across the country increased (increased by 9.36% and 6.03% respectively), and the growth rate slowed down and was lower than the GDP growth rate of the same year. The decrease in the cost of medicines and the average cost of medicines for outpatient visits (decreased by 15.25% and 3.38% respectively) reflects the overall steady trend in the increase of medical expenses in tertiary public hospitals, and the unreasonable growth has been effectively controlled.
However, through this performance appraisal, some problems were also found. For example, the level of hospital management needs to be improved. About one-third of the hospital’s asset-liability ratio is greater than 50%. The pressure to resolve the long-term debt of public hospitals in compliance with the regulations is still high. The situation with high patient satisfaction is different. The satisfaction of medical staff is still not high, and their enthusiasm needs to be further mobilized.
(Our reporter Chen Haibo)