title: Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.
abstract: BACKGROUND
  With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period.
  
  
  METHODS
  We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model.
  
  
  RESULTS
  There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001), from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present.
  
  
  CONCLUSIONS
  These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.
authors: Peking University Medical Informatics Center, Peking University, Beijing, China. lzhao@bjmu.edu.cn
authors: Lue-Ping
authors: LP
authors: Zhao
authors: Guo-Pei
authors: GP
authors: Yu
authors: Hui
authors: H
authors: Liu
authors: Xie-Min
authors: XM
authors: Ma
authors: Jing
authors: J
authors: Wang
authors: Gui-Lan
authors: GL
authors: Kong
authors: Yi
authors: Y
authors: Li
authors: Wen
authors: W
authors: Ma
authors: Yong
authors: Y
authors: Cui
authors: Beibei
authors: B
authors: Xu
authors: Na
authors: N
authors: Yu
authors: Xiao-Yuan
authors: XY
authors: Bao
authors: Yu
authors: Y
authors: Guo
authors: Fei
authors: F
authors: Wang
authors: Jun
authors: J
authors: Zhang
authors: Yan
authors: Y
authors: Li
authors: Xue-Qin
authors: XQ
authors: Xie
authors: Bao-Guo
authors: BG
authors: Jiang
authors: Yang
authors: Y
authors: Ke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China; D003363:Cost Control / Q000639:trends*; D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence; D005260:Female; D033161:Government Regulation; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000191:economics / Q000331:legislation & jurisprudence; D017052:Hospital Mortality / Q000639:trends; D006779:Hospitals, Public / Q000191:economics* / Q000331:legislation & jurisprudence; D006784:Hospitals, Teaching / Q000191:economics* / Q000331:legislation & jurisprudence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D011787:Quality of Health Care / Q000191:economics* / Q000331:legislation & jurisprudence
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