Performance Comparison of Public Hospitals Between 2014 and 2018 in Different Regions of Guangdong Province, China, Following 2017 Medical Service Price Reforms

Effective analysis of job satisfaction among medical staff in Chinese public hospitals: a random forest model

Objective

This study explored the factors and influence degree of job satisfaction among medical staff in Chinese public hospitals by constructing the optimal discriminant model.

Methods

The participant sample is based on the service volume of 12,405 officially appointed medical staff from different departments of 16 public hospitals for three consecutive years from 2017 to 2019. All medical staff (doctors, nurses, administrative personnel) invited to participate in the survey for the current year will no longer repeat their participation. The importance of all associated factors and the optimal evaluation model has been calculated.

Results

The overall job satisfaction of medical staff is 25.62%. The most important factors affecting medical staff satisfaction are: Value staff opinions (Q10), Get recognition for your work (Q11), Democracy (Q9), and Performance Evaluation Satisfaction (Q5). The random forest model is the best evaluation model for medical staff satisfaction, and its prediction accuracy is higher than other similar models.

Conclusion

The improvement of medical staff job satisfaction is significantly related to the improvement of democracy, recognition of work, and increased employee performance. It has shown that improving these five key variables can maximize the job satisfaction and motivation of medical staff. The random forest model can maximize the accuracy and effectiveness of similar research.

The influence of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in Chinese low-income areas

BACKGROUND

In recent years, due to the increasing number of cross-regional medical patients, countries around the world have issued a series of policies or regulations to reduce their out-of-pocket burden. In this context, this study intended to explore the impact of the Spatio-temporal characteristics of cross-regional medical treatment on total medical expenses, medical insurance payments, and out-of-pocket expenses of patients with malignant tumors in low-income areas.

METHODS

This study included 54,904 data of cross-provincial medical treatment of malignant tumor patients insured in Heilongjiang Province, China in 2020. Firstly, Microsoft Excel 2019 and ArcGIS 10.2 were applied to conduct a descriptive analysis of the Spatio-temporal characteristics of their cross-provincial medical treatment. Then, binary and multivariate logistic regression models were used to explore the specific impact of economic level and geographical distance of medical regions on total medical expenses, medical insurance payments, and out-of-pocket expenses.

RESULTS

The number of cross-regional medical patients showed a gradual upward trend from February to December, and fell back in January. They were concentrated in regions with high economic level and short distance from the insured region, where were more likely to form the group with high out-of-pocket expenses (AOR = 3.620, P < 0.001; AOR = 1.882, P < 0.001). While this possibility in middle-distance medical regions were less (AOR = 0.545, P < 0.001). Afterwards, two sensitivity analysis methods showed that the results were robust.

CONCLUSION

The number of cross-regional medical patients with malignant tumors in low-income areas is affected by seasonal factors, meanwhile, their total medical expenses, actual medical insurance payment levels, and out-of-pocket expenses are all affected by the economic level and geographical distance of medical regions. And the middle-distance medical regions may be the best choice for patients with planned cross-regional medical treatment. These provide some evidence for policymakers to improve the fairness and sustainability of medical security for cross-regional medical patients and reduce their direct economic burden of disease.

Coping Ability and Promotion Countermeasures of Medical and Health Institutions Reputation Crisis: A Case Study in Hubei Province

At present, the doctor–patient relationships in Chinese medical and health institutions (MHI) are increasingly tense, and the reputation crisis challenges are being faced by MHI more frequently. However, the reputation crisis management level of the MHI is directly related to the future development and construction of the MHI and is an important management link that cannot be ignored. Therefore, how to quantify the impact of the relevant crisis on hospitals has become a major problem. First of all, this paper uses the situational crisis communication theory (SCCT) to combine the characteristics of hospital reputation crisis with the theory and classification of MHI reputation crisis from three perspectives: victim crisis, accidental crisis, and preventable crisis. Second, a more comprehensive analysis of MHI reputation crisis management model is conducted in the research cases, based on the relevant data of Union Hospital, Tongji Medical College Huazhong University of Science and Technology (UH), Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology (TJ), Zhongnan Hospital of Wuhan University (ZN), Renmin Hospital of Wuhan University (RM), and Maternal and Child Hospital of Hubei Province (MC). Third, we divide MHI reputation positioning into four types, namely robust, growth, fragile, and sensitive, and innovate SCCT to build a new MHI crisis classification type. Finally, this paper provides appropriate crisis management strategies for sample MHI based on the above examples and theories. Furthermore, we realize the lifecycle management of MHI reputation by identifying, evaluating and responding to reputation issues. This study provides a theoretical reference for the MHI reputation crisis management level and the adjustment of future management strategies.