ObjectiveTo investigate the demand of pediatric health service, the current situation of resource allocation and the equity of health service, so as to provide guidelines for optimizing the resource allocation of pediatric health service in Sichuan province.MethodsA questionnaire of all healthcare institutions with legal capability from a total of 183 prefectures in Sichuan province was performed in 2015. We described the demand of pediatric health service by two-week hospital visit rate, the proportion of no-visit rate within two-weeks, hospital admission rate, and the patient required hospitalization rate. We assessed current situation of resource allocation, equity and accessibility by analyzing Gini coefficient, Lorenz curve and thermodynamic diagram.ResultsThe demand of pediatric health service in Sichuan province was huge and the current resource allocation can be shown a " inverted triangle” form. According to population distribution, the Gini coefficients of physician, bed and equipment were 0.47, 0.40 and 0.49, respectively, which represented inequality in resource allocation. By location, the Gini coefficients of physician, bed and equipment were 0.82, 0.77 and 0.81, respectively, which indicated an absolutely unfair situation.ConclusionsThe health resources of pediatric in Sichuan province are limited, the distribution is unbalanced, and the supply of pediatric healthcare is not compatible with demand. The lack of resources and waste coexist simultaneously. Furthermore, the fairness of distribution in terms of geographical areas is far less than that in terms of population. The accessibility of superior health resources is low.
Objectives To construct patient trust evaluation index system based on the background of hierarchical medical system, and to provide reference for the evaluation of the degree of patient trust on medical institutions and offer guidence to the implementation and further improvement of the hierarchical medical policy in China. Methods Based on literature review, the modified Delphi method was used to carry out 2 rounds of expert consultations from 11 experts in different fields to determine the indicators of patient trust evaluation index system. Results Questionnaire recovery rates of 2 rounds were 100.00% and 90.91%, the expert authority coefficient was greater than 0.75, the coefficient of variation of each index was less than 0.25, and the coordination coefficient of experts in the total index were 0.236 and 0.424 (P<0.001). Patient trust evaluation index system was preliminary constructed including medical environment, service trust, technical skills, pharmaceutical and equipment, the overall trust 5 first-level indexes and 20 level two indexes. Conclusions The patient trust evaluation index system can be used to evaluate patients' trust in different levels of medical institutions under the hierarchical medical system.
This paper analyzed the four aspects of the medical consortium both in China and abroad, including evaluation of object, theoretical basis and model, content and method, and provided reference for construction and development of medical consortium evaluation in China.
Objective To further optimize the performance appraisal system based on resource based relative value scale (RBRVS) by evaluating the surgical operation ability of surgeons. Methods From January 1, 2019 to December 31, 2019, all patients in diagnosis related groups（DRG）group named laparoscopic cholecystotomy without common bile duct exploration and code 51.2300 in International Classification of Diseases ICD-9-CM-3 were retrospectively collected. The key indicators related to surgical operation ability of surgeons were selected through literature review and expert interviews, and the evaluation model of surgical operation ability of surgeons was established by principal component analysis. Results The RBRVS coefficients of each operation were further modified by the constructed evaluation model of surgeons' surgical ability. After adjustment, the RBRVS coefficients of different surgeons were different. Conclusion The evaluation model of surgical operation ability of surgeons is operable, which can reflect the difference of different doctors' level and ability in the treatment of the same medical service item, and promote the refined development of hospital performance management.