Suchergebnisse

Abstract Background Third-grade hospitals in Beijing have been rapidly developing in capacity and scale for many years. These hospitals receive a large number of patients, and ensuring their efficient operation is crucial in meeting people's healthcare needs. In this context, a study of their relative efficiency and productivity would be helpful to identify the driving factors and further improve their performance. Methods After a review of literature, the current numbers of open beds and employees were selected as input variables. The number of outpatient and emergency visits and the number of discharged patients were selected as output variables. A total of 12 third-grade Class A general public hospitals in Beijing were selected for a preliminary study. The panel data from 2006–2009 were collected by the National Institute of Hospital Administration, Ministry of Health of P.R. China. Descriptive analysis and data envelopment analysis were used to analyze the data using Stata 10.0 and DEAP(V2.1) software. Results In the 2006–2009 period, descriptive results show that sample hospitals continuously expanded their capacity and scale, with growth rate of total revenue being the highest among all variables. The DEA results show that the average annual growth rate of productivity was 26.7%, and the rates were 47.3%, 21.3% and 13.8% respectively for two consecutive years. The average annual growth rate of technological change was 28.3%, and the rates were 49.4%, 21.5% and 16.4% respectively for two consecutive years. The average annual growth rate of technical efficiency change was -1.3%, and the rates were -1.4%, -0.02% and -2.2% respectively for two consecutive years. Conclusions The sample hospitals in Beijing experienced substantial productivity growth, but annual growth rates were declining. Substantial technological change was the main contributor to the growth. Although some hospitals exhibited improvements in technical efficiency, there was a slight decline in general. To improve overall efficiency and productivity, both government and hospitals need to further drive positive technological change, technical change, and allocative efficiency of public hospitals. More empirical studies are needed to include more hospitals of all three grades at a larger scale.

Abstract

Aim
To survey the use of alcohol, and its correlates by mental health professions in China, a nation where there is rapid increase in alcohol consumption and problems.


Methods
As a part of a large-scale, nation-wide online survey of healthcare professionals, we collected demographic variables and other health-related variables anonymously. The Alcohol Use Disorder Identification Test-Concise (AUDIT-C) was used to collect data on alcohol use.


Results
13,980 mental health professionals completed the survey (4382 doctors, 9339 nurses and 259 clinical psychologists), representing 64% of the total targeted. Respondents were predominantly female (75.1%). Alcohol consumption was reported by 41.8% of participants (by 53.9% of doctors, 36.2% of nurses and 40.5% of clinical psychologists). Based on the cut-off scores of the AUDIT-C (≥3 for women and ≥4 for men), 7.5% were classified as probable alcohol misusers in the past year, and the rates were 10.2% in doctors, 6.3% in nurses and 5.8% in clinical psychologists. Multiple logistic regression showed that male sex (OR = 3.772; CI = 3.206–4.439), being a doctor (OR = 1.259; CI = 1.052–1.506), being divorced or widowed (OR = 1.979; CI = 1.467–2.666), having an associate degree or less (OR = 1.809; CI = 1.040–3.147), working in Northeast China (OR = 1.538; CI = 1.281–1.848) and the habit of smoking (OR = 3.345; CI = 2.280–3.967) were significantly associated with alcohol misuse.


Conclusions
Alcohol use and misuse were relatively common among mental health professionals in China, and male sex, being a doctor, with lower education, working in Northeast China and cigarette smoking were significant associations. Awareness and interventions are recommended to promote healthier use of alcohol in this professional group, especially among risk subgroups.

Objective: To study the socio-demographic characteristics, the working environment, and the level of career satisfaction among psychiatry residents in China. Method: This was a part of a large-scale, nation-wide online survey of hospitals, healthcare professionals, and patients. Data, including socio-demographics, work hours, income, job satisfaction, and intention to quit were collected anonymously. Respondents also completed the Minnesota Satisfaction Questionnaire (MSQ). Results: One thousand sixty residents nested in 32 psychiatric hospitals in 29 provinces in China completed the survey. Respondents were predominantly female (69.0%), worked an average of 47.8 ± 11.6 h per week, and 28.97% had experienced medical disputes in the previous year. The top three reported reasons for dissatisfaction were low pay (50.1%), contentious doctor-patient relationships (17.6%), and high workload (10.8%). An intention to quit their current job was reported by 18.7% of residents. The overall mean MSQ score was 73.8 ± 13.8, with significant differences across post-graduate training years and regions. A multilevel regression analysis found that a higher MSQ score was significantly associated with fewer years in residency, shorter work hours, higher monthly pay, having medical liability insurance, and feeling satisfied with the level of doctor-nurse cooperation, their hospitals' medical disputes prevention/management, and the healthcare workers' social environment. Conclusion: Psychiatry residents in China are predominantly female and well-educated. They are only moderately satisfied with their career. Poor salaries, contentious doctor-patient relationships and high workload are among their top complaints and may explain why a considerable proportion are intending to leave their current residency. More support from the government regarding residents' salaries, workload and working environment may help improve their job satisfaction and retention, ensuring that China will have a pool of well-trained and engaged psychiatrists for ...

Objectives: Mental healthcare has gained momentum and significant attention in China over the past three decades. However, many challenges still exist. This survey aimed to investigate mental health resources and the psychiatric workforce in representative top-tier psychiatric hospitals in China. Methods: A total of 41 top-tier psychiatric hospitals from 29 provinces participated, providing data about numbers and types of psychiatric beds, numbers of mental health professionals, outpatient services and hospitalization information covering the past 3 years, as well as teaching and training program affiliation. Results: Significant variations were found among participating hospitals and across different regions. Most of these hospitals were large, with a median number of psychiatric beds of 660 (range, 169-2,141). Child and geriatric beds accounted for 3.3 and 12.6% of all beds, respectively, and many hospitals had no specialized child or geriatric units. The overall ratios of psychiatrists, psychiatric nurses, and psychologists per bed were 0.16, 0.34, and 0.03, respectively. More than 40% of the hospitals had no clinical social workers. Based on the government's staffing guidelines, less than one third (31.7%) of the hospitals reached the lower limit of the psychiatric staff per bed ratio, and 43.9% of them reached the lower limit of the nurse per bed ratio. Conclusion: Although some progress has been made, mental health resources and the psychiatric workforce in China are still relatively insufficient with uneven geographical distribution and an acute shortage of psychiatric beds for children and elderly patients. In the meantime, the staffing composition needs to be optimized and more psychologists and social workers are needed. While addressing these shortages of mental health resources and the workforce is important, diversifying the psychiatric workforce, promoting community mental health care, and decentralizing mental health services may be equally important.