Objective To investigate current situation of medical service and management in Gaozha Central Township Health Center (GzC), so as to provide baseline data for township health centers in both key techniques research and product development of drugs allocation and delivery. Methods A questionnaire combined with a special interview was carried out, which included the general information, human resources, medical service and management, and the practice of essential medicine list. Results a) The hardware condition of GzC was not good enough, and the economic status of the service recipients was lower than the average level of both Wuzhong City and China mainland; b) The constituent ratio of general practitioner (GP) and nurse, and GP and laboratorian were all lower than those of national level, while, the constituent ratio of GP and technician was a little bit higher. GzC was in short of medical technical personnel and, especially, the professional pharmacists. The logistics technical workers were as the same proportion as the nurses. The medical technical personnel without professional education background accounted for 3.4%, and about 38% of the staff members had no college degree, about 86.2% had at most primary profession titles. There was no personnel turnover of GzC in recently years; c) The bed utilization ratio was lower than national level (46.4% vs. 60.7%), while the average duration of stay and the in-patient and out-patient service workload of GP were longer or heavier than national level (8 vs. 4.8, 9 vs. 8.3, 4 vs. 1.3); d) The out-patient service in 2010 decreased 26.9% compared to 2009; and the in-patient service in 2010 decreased 42.4%; e) The average medical expense per outpatient and per inpatient increased 127.3% and 56.2%, respectively in 2010 compared to 2009; and f) Essential medicine list was put into practice in April 1st of 2010 and there was only 195 species available in GzC, which has not met the requirements of the national essential medicine list. Conclusion In order to meet the standards of general rural township health center in western China, GzC needs to cope with challenges of insufficient hardware conditions, short of staff, unreasonable personnel structure, low educational background and professional title of the staff, none human resources flow and low technical level of medical service. GzC dose well in drug expenses control, and the hospitalization costs are lower than those of the national level. However, it increases rapidly in 2010. The management of GzC may be influenced by zero-profit sale of the essential drugs, and appropriate subsidy and policy support are necessary to maintain its service quality. And it is required to complement the medicine based on the evidences, to carry out staff training and usage guidance of essential medicine, and to finally guarantee the safe and reasonable use of medicines.
ObjectivesTo analyze the balance of medical human resource allocation in Chengdu and to discuss the impact of human resource allocation structure on the hospital’s medical service capabilities, so as to provide a theoretical basis for the hospital to optimize the talent team structure.MethodsThe Moran’s index and Gini coefficient were used to evaluate the spatial aggregation and grade distribution difference of human resources allocation, respectively. The case mix index (CMI), the length of hospital stay, and the difficulty of surgery were used as outcome variables, and a multiple regression analysis model was established to explore the impact of human resource indicators on the hospital’s medical service capabilities.ResultsThe distribution of doctors showed an obvious spatial aggregation in Chengdu, and there was a positive spatial correlation (Moran’s Idoctor=0.290); the distribution of nurses had no obvious spatial aggregation (Moran’s Inurse=0.102). Under different medical service capacity segments, the Gini coefficient of doctors was 0.518, and the Gini coefficient of nurses was 0.576, both exceeding 0.5, indicating that the distribution of medical human resources in different levels of hospitals was considerably different. The regression results showed that the expansion of the quantity of senior title doctors and the proportion of medical care both could improve the hospital’s CMI. The increase in the quantity of doctors with senior titles also had a certain impact on improving the hospital’s surgical capabilities. The expansion of the proportion of medical care could lead to a slight increase in the length of patients' hospital stay.ConclusionsOptimizing the allocation structure of medical human resources in different regions and hospitals with different levels is an important task in the construction of a hierarchical diagnosis and treatment system. It is necessary to further integrate medical human resources throughout the whole city and strengthen personnel training and team building in primary health institutions. Hospitals at different levels should implement their own development positioning and further optimize their human resource allocation structure according to development needs. Tertiary hospitals should pay more attention to the cultivation of senior professional doctors, optimize the proportion of medical care, and improve the hospital’s medical service capabilities. The primary health institutions should pay attention to the comprehensive construction of medical personnel, and strengthen the development of the team of general practitioners, so as to achieve a comprehensive improvement of the city’s medical service capabilities.
ObjectiveTo understand the current status of healthcare human resources (HHR) in a large public hospital, predict the HHR demand aligned with the development of the hospital, and provide reference basis and feasible solutions for HHR planning for high-quality development of the large public hospital. MethodsBased on grey model and auto regressive integrated moving average model, a variance reciprocal method for weight allocation was applied to set up the combination forecasting model. Different types of HHR demand of the large public hospital from 2024 to 2026 were predicted and the accuracies of the three different model predictions were compared. ResultsThe numbers of total personnel, health technical personnel, physicians, nurses, and technicians predicted by the combination forecasting model for 2026 were 17654, 13041, 4389, 6198, and 2264, respectively. The corresponding average annual growth rates from 2024 to 2026 were 5.54%, 5.55%, 5.37%, 4.27%, and 5.60%, respectively. Compared with the two single forecasting models, the combination forecasting model had the smallest average absolute errors, mean squared errors, and mean absolute percentage errors for predicting the numbers of total personnel, nurses, and technicians. It also had the smallest average absolute error and mean absolute percentage error for predicting the number of health technical personnel, and the smallest average absolute error for predicting the number of physicians. ConclusionsCompared with the single forecasting model, the combination forecasting model shows fewer system errors and better predictive results. The demand for total personnel, health technical personnel, physicians, nurses, and technicians of this large public hospital will continue to increase, so planning and reserving staff in advance is a key to high-quality development of the hospital.
Objective To explore the personnel framework strategy of multi-disciplinary treatment (MDT) for colorectal cancer. Methods Combined the characteristics of large public hospital, with recognized treatment pathway in international MDT for colorectal cancer and management of medical human resource, colorectal cancer MDT project team summarized a system of multi-disciplinary treatment-working for colorectal cancer of West China Hospital (MDT-CRC-WCH) by own management mechanism and subject feature. Results Based on the main four principles——whole, match, voluntary and interactive, MDT-CRC-WCH constructed reciprocation “concentric circle” with the team of directors, coordinators, colorectal surgeons, related professors, nursing and other assistants.Conclusion With construction of multi-layers, MDT for colorectal cancer is completing MDT personnel framework and suitable layers relation. And how to construct prolong active and innovative system of MDT human resource management needed more research.
A new human resource management system in West China Hospital of Sichuan University has been constructed to inspire work enthusiasm and innovation of the front-line medical staffs, strengthen the cohesion of the hospital, better service for patients, and promote high-quality development of the hospital. This paper introduced it and provided references for related researches.
Objective To understand the current situation of medical service and management in Luxi township health center (LxC) in Yongxin county of Jiangxi province, so as to provide baseline data about drug allocation, logistic key techniques research and products development for township health centers. Methods By means of questionnaire and focus interview, the LxC was investigated from the following aspects: general information, human resources, medicine list, basic device configuration, medical service and management, as well as service efficiency. Results a) Yongxin county including 13 village committees covers an area of 86 km2, with the population of 22 300 in 2009, and it pertains to a backward area with the annual per capita income of RMB 4 100 yuan; b) Among the total 28 staffs in LxC, 78.6% were health workers; the general practitioner (GP)/nurse ratio was about 1?0.58; the proportion of GP, nurses, medical technicians, other staffs was 54.55%, 31.82%, 9.09% and 4.54%, respectively; the proportion of bachelor degree, junior college graduation and secondary technical school graduation was 9.1%, 13.6%, and 77.3%, respectively; and the ratio of elementary, middle, and high professional title of health workers was 15?5?1; c) There were 625 species of drugs in LxC in 2009, and the hospital beds approved by government were 0.69 per thousand agricultural persons, which, however, were 1.15 in fact. The rate of 51 basic equipments shown in national regulation was actually 76.5%, and the readiness and utilization rate of existing 40 equipments was 92.5%; and d) In 2009, the outpatients were 12 150 person-time, with the average cost of RMB 29.39 yuan; the hospital discharge was 1 589 person-time, with the average stay of 12 days and the average cost of RMB 490.05 yuan; the vaccine inoculations were 5 053 person-time; among the total income, the medical service income accounted for 73.2%, while the drug income accounted for 53.7%; the personnel expenditure was 31.0% of the total, and the balance of income and expenditure was RMB –263 500 yuan. Conclusion The hardware condition of LxC is not so good owing to the financial difficulties of Yongxin county and Jiangxi provincial government. In comparison with the whole country, although the professional title structure is ok, health workers are still not enough, with unreasonable specialty structure and low educational background. The rate of basic equipments and the approved hospital beds per thousand agricultural persons are low. There are 625 species of drugs, containing 218 species shown in 2009 national essential medicine list. And the other conditions are as follows: no information system, lack of public health service, short of financial input, high ratio of “running hospital by selling drugs”, and low efficiency of medical service. So the top priority of LxC construction should be figuring out all of the above issues, and better serving the people.
Objective To understand current situation of medical service and management in Yong’an Central Township Health Center (YaC) through on-the-spot investigation, in order to provide references for personal employment and essential medicines list implement in township health centers. Methods Questionnaire and focus interview were carried out, which included the general information, human resources, medical service and management, and the practice of essential medicines list. Results The hardware equipments of YaC were fine, and the target population had fairly good health and economy status. The ratio of General Practitioner (GP)/ nurse and GP/ pharmacist were all above the national average level. The members with college degree and above accounted for 61.6%, and about 88% staffs were with or below primary profession titles. There was a balance between personnel flow out and in. The drug income accounted for 53.6% of the whole in 2009 and the medical expenses increased compared to 2008. Essential medicines list was put into practice in April 1st of 2010 with no relevant technical documents as correspondence. Conclusion YaC, as a good representative of fairly well-off rural Township Health Center in western China, needs to cope with challenges of irrational personnel structure, low educational background and professional title of the staff and human resources flow, and requires developing policy and adopting measures step by step. The management of YaC may be influenced by zero-profit price of the essential medicine, and appropriate subsidy and policy support are necessary to maintain current service quality.
ObjectiveTo explore the application effect of itinerant strengthening post in ophthalmic day operating room.MethodsIn June 2019 (before the establishment of the itinerant strengthening post) and January 2020 (after the establishment of the itinerant strengthening post), satisfaction of 21 ophthalmic surgeons in the ophthalmic day operation room of the West China Hospital of Sichuan University on intraoperative nursing cooperation, and coping ability scores of operation in key links, satisfaction with scheduling and workload, as well as complaints and accusations received by surgeons of 15 ophthalmological nurses in the ophthalmic day operation room of the West China Hospital of Sichuan University were collected. The total volume of eye day surgeries and the length of the day operating room open in the second half of 2018 and 2019 were retrospectively collected.ResultsAfter the establishment of the itinerant strengthening post, the coping ability score of operation in key links of ophthalmological nurses was improved [(3.28±0.72) vs. (4.67±0.72), P<0.01]. In terms of surgeons’ satisfaction with intraoperative nursing cooperation, with the exception of aseptic operation, the other items were improved (P<0.05). The surgical nurses’ satisfaction with scheduling and workload [(3.30±0.77) vs. (4.47±0.67), P<0.01]; nurses’ complaints and accusations received by surgeons [(3.60±1.18) vs. (2.33±0.82), P<0.01] were improved. The volume of eye day surgery from July to December 2019 increased by 6.58% over the same period in 2018, and the average open time of the operating room increased by 1.88%.ConclusionThe setting up of itinerant strengthening posts in the ophthalmology day operation room is conducive to strengthening the strength and business guidance of the nurses’ key links in the operation room in a timely and effective manner. It can optimize the allocation of human resources in the operating room as much as possible when the existing nursing staff is in short supply, and improve the quality and efficiency of ophthalmic surgery nursing, which is worthy of promotion and application.
Objective To understand the current situation of medical service and management in Xintian Central Township Health Center (XtC) through on-the-spot investigation, and to provide references for development of key techniques and products for township health centers in medicine allocation and delivery. Methods The questionnaire and the focus interview were carried out, which included the general information, human resources, medical service and management, as well as the practice of essential medicine list. Results a) The hardware conditions of XtC were not good enough, and the income of Lintao county and Gansu provincial government fell short of their needs; b) The General Practitioner (GP)/nurse ratio was higher than that of the national level, the GP/pharmacist ratio was a little bit lower, and the GP/laboratorian ratio reached the national level. There was only one medical technician. There was about 27.5% staff members having no college degree, and about 81% having at most primary profession titles. There were 26 medical workers allocated to XtC in recent two years and only one GP left; c) In 2009, the bed utilization ratio was a little bit higher than the national level (109% vs. 60.7%), while the average length of stay was longer than the national level (6 vs. 4.8); d) The outpatient service in 2010 increased by 17.6% compared to 2009 and the inpatient service in 2010 decreased by 17%; e) The average medical expense per outpatient and per inpatient increased by 23.5% and 14.9%, respectively, in 2010 compared to 2009; f) The essential medicine list (EML) was put into practice in June, 2010. The current count of medicine in hospital was 767, far beyond the EML demand. Conclusion XtC, as a basic rural Township Health Center in Western China, overtakes the burden of healthcare service for local population. The policy of “selecting graduates to work in Township Health Center” made by Gansu government ensures sufficient personnel reserve for rural Township Health Center. XtC needs to cope with challenges of insufficient hardware conditions, unreasonable personnel structure, low educational background and profession title of the staff, and low technical level of medical service. XtC has a big ratio of medicine income and the expense of outpatient is lower than that of the national level. The management of XtC may be influenced by zero-profit price of the essential medicine, and appropriate subsidy and policy support are needed to maintain its service quality. And it is necessary to carry out evidence-based selection of the essential medicine account and develop staff training and essential medicine usage guidance, so as to support the medicine used safely and rationally.
Optometry has become the second class course under the allied health professions since 2012, and has been the National undergraduate enrollment directory. According to the definition of optometry provided by the World Council of Optometry, the jobs of optometrist in China include the basic eye care, basic optometry, contact lens fitting, binocular vision anomaly treatment, strabismus and amblyopia treatment, low vision treatment, special ocular examination, maintenance of equipment related to optometry, operation and sales management. At present, the demand of professional optometrist is great. However, the development of optometrical education is limited by the lack of professional ranks. The professional ranks and titles for optometrist, corresponding registration and examination system should be established by the Ministry of Health as soon as possible, in order for the development of optometrical education and human resource management.