Background: In March 2009, the Chinese government formally launched a new round of healthcare reform. As the city with the highest concentration of high-quality medical resources in China, in the past 10 years, Beijing has also been exploring medical reforms. This article studied the performance and development of the 10 tertiary general public hospitals managed by Beijing Municipal Hospital Management Centre to provide policy basis for further deepening Beijing public hospital reform and improving hospital efficiency.
BackgroundBeijing is a city with high concentration and congestion of quality medical resources in China. While moderate slack seems to be beneficial to the improvement of medical quality. The actual relationship between hospital slack resources and their performance deserves further exploration. The study aims to analyze the slack resources of public hospitals in Beijing and investigate the relationship between slack and hospital financial performance. Finding a reasonable range of slack to optimize resource allocation.MethodsThe panel data of 22 public hospitals in Beijing from 2005 to 2011 were selected as the sample, and the DEA model was applied to measure the main variable using DEAP 2.1. Descriptive statistical analysis was performed using Excel and STATA 15. Pearson correlation coefficient analysis and variance inflation factor test were performed for each variable to avoid multicollinearity. The HAUSMAN test was used to determine the appropriate panel regression model, and then to analyze the influence relationship between the variables.ResultsFrom 2005 to 2011, hospital slack resource transitioned from high to low. The slack measured by the DEA model has an inverted U-shaped relationship with financial performance, with ROA increasing from 4.088 to 8.083 when slack increases from 0 to about 0.378, and then showing a decreasing trend; slack measured by financial indicators has a transposed S-shaped relationship with financial performance, with ROA increasing when slack increase from 3.772 to 5.933.ConclusionsThe slack resources of Beijing public hospitals decreased year by year from 2005 to 2011. Moderate slack resources are conducive to the improvement of healthcare quality, but when slack resources increase to a certain level, it will have a negative impact on healthcare quality. Therefore, hospital managers should control the slack within a moderate range according to the hospital operation policy and development plan to obtain the best performance.
ObjectiveThis study aims to explore the relationship between slack resources and cost consumption index in tertiary and secondary hospitals and to provide targeted healthcare resource utilisation recommendations for tertiary and secondary hospital managers.DesignThis is a panel data study of 51 public hospitals in Beijing from 2015 to 2019.SettingTertiary and secondary public hospitals in Beijing. Data envelope analysis was used to calculate the slack resources. Regression models were used to explore the relationship between slack resources and healthcare costs.ParticipantsA total of 255 observations were collected from 33 tertiary hospitals and 18 secondary hospitals.Outcome measuresSlack resources and healthcare costs in tertiary and secondary public hospitals in Beijing from 2015 to 2019. Linear or curve relationship between slack resources and healthcare costs in tertiary and secondary hospitals.ResultsThe cost of healthcare in tertiary hospitals has always been higher than in secondary hospitals, and the slack resources in secondary hospitals have always been worse than in tertiary hospitals. For tertiary hospitals, the cubic coefficient of slack resources is significant (β=−12.914, p<0.01) and the R2of cubic regression is increased compared with linear and quadratic regression models, so there is a transposed S-shaped relationship between slack resources and cost consumption index. For secondary hospitals, only the first-order coefficient of slack resources in the linear regression was significant (β=0.179, p<0.05), so slack resources in secondary hospitals were positively related to the cost consumption index.ConclusionsThis study shows that slack resources’ impact on healthcare costs differs in tertiary and secondary public hospitals. For tertiary hospitals, slack should be kept within a reasonable range to control excessive growth in healthcare costs. In secondary hospitals, keeping too many slack resources is not ideal, so managers should adopt strategies to improve competitiveness and service transformation.
Background Clinicians in Chinese public hospitals face a complex and severe clinical practice environment, and the individual performance of clinicians is key to improving the output of the healthcare industry. This study aims to explore the mechanism of slack resources in improving individual performance of clinicians and the role of job satisfaction in this process, while the study framework is based on the widely applied Job-Demands Resources theory. Methods Based on the study framework composed of slack resources, individual performance, and job satisfaction, hypotheses have been put forward, and questionnaires have been distributed to representative clinicians in tertiary public hospitals. Finally, 318 valid data collected from clinicians have been obtained. To verify the hypotheses, multiple linear regression models have been established to explore the relationship between variables, and the three-stage regression models have been used to verify the presence of mediating role. Results All four hypotheses proposed in this study have been proved to be held. Clinicians' job satisfaction has played a mediating role in the impact of slack resources and its three dimensions on individual performance. Among them, there has been a complete mediating role for staff slack, while time and space dimensions have played a partial mediating role in the impact of slack resources on individual performance. Conclusions In public hospitals in environments where behavior is subject to significant government interference, it is necessary and feasible to retain appropriate slack resources to improve individual performance. From the perspective of resources management in hospitals, it is necessary for public hospitals to implement a strategy of reserving an appropriate portion of time, staff and space in order to have the conditions to improve clinicians' satisfaction. The existence of slack resources in public hospitals can improve the job satisfaction of clinicians, and then improve the individual performance through the process.
Background: The individual performance of clinicians is key to improving the output of the healthcare industry. Clinicians in Chinese public hospitals have an important functional position and face a complex and severe clinical practice environment. This study aims to explore the mechanism of slack resources in improving individual performance of clinicians and the effect of job satisfaction in this process. Methods: Based on the study framework composed of slack resources, individual performance, and job satisfaction, hypotheses have been put forward, and questionnaires have been distributed to representative clinicians in tertiary public hospitals. Finally, 318 valid data collected from clinicians have been obtained. To verify the four conditions of the mediation hypothesis, multiple linear regression models have been established to explore the relationship between variables. Results: Clinicians' job satisfaction has played a mediating role in the impact of slack resources and its three dimensions on individual performance. Among them, there has been a complete mediating effect for staff slack, while time and space dimensions have played a partial mediating role in the impact of slack resources on individual performance. Conclusions: In public hospitals in environments where behavior is subject to significant government interference, it is necessary and feasible to retain appropriate slack resources to improve individual performance. From the perspective of resources management in hospitals, it is necessary for public hospitals to implement a strategy of reserving an appropriate portion of time, staff and space in order to have the conditions to improve clinicians' satisfaction. The existence of slack resources in public hospitals can improve the job satisfaction of clinicians, and then improve the individual performance through the process.
Background: In recent years, the scale of Chinese hospitals and the resources they occupy are in a situation of rapid expansion. Whether these resources can be fully and effectively used and whether they are conducive to the improvement of the quality of medical care remains to be studied. Methods: The DEA model and the panel regression model were used to analyze the slack resources status, and to study the relationship between slack resources and the quality of medical care. Results: First, slack in 23 hospitals was on the rise from 2015 to 2018, with significant reduction in 2019. Second, low-risk mortality increased from .014% to .003% when slack resources increased from 0 to about 0.225. However, the low-risk mortality rate increased to .086% when slack resources increased to about .577. Conclusions: There is an inverted U-shaped curve relationship between slack resources and the quality of medical care in public hospitals in Beijing. That is, a small number of slack resources in the hospital is conducive to the improvement of the quality of medical care, but when it increase to a certain level it will have a negative impact on the quality of medical care.
Background:The development level of public hospitals has a direct impact on people's health. The reform of the medical industry in China has been gradually underway in recent years, while hospitals face a complex and uncertain environment. This study aims to explore the mechanism of resources slack in buffering environmental uncertainty and promoting innovation in public hospitals.MethodsBased on previous literature related to environmental adaptability, resources slack, and innovation performance, this study has conducted a literature review and has established a study framework. A questionnaire survey has been conducted among clinicians in representative tertiary public hospitals in Beijing. A total of 318 valid data have been eventually obtained, while regression models have been used to analyze the data.ResultsInnovation performance has played a mediating role in the impact of both resources slack and its three dimensions on environmental adaptability of public hospitals. Among them, there has been a complete mediating effect for time slack, while there has been a partial mediating effect for staff and space dimensions.ConclusionThis study found that resources slack in public hospitals can improve environmental adaptability by affecting innovation performance. It is necessary for public hospitals to reserve resources slack to ensure that there is sufficient condition for innovation in the face of uncertain changes.
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