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: In recent years, the scale of Chinese hospitals and the resources they occupy are in a situation of rapid expansion. Whether these resources are conducive to improving 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, from 2015 to 2018, slack resources was on the rise in 23 hospitals, with a significant reduction in 2019. Second, low-risk mortality decreased from .014% to .003% when slack resources increased from 0 to about .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 China. A small number of slack resources in the hospital is conducive to the improvement of the quality of medical care, but when it increases to a certain amount, it will be detrimental to the quality of medical care.

Objective This 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.Design This is a panel data study of 51 public hospitals in Beijing from 2015 to 2019.Setting Tertiary 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.Participants A total of 255 observations were collected from 33 tertiary hospitals and 18 secondary hospitals.Outcome measures Slack 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.Results The 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 R2 of 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.Conclusions This 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: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.

Background Beijing 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. Methods The 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. Results From 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. Conclusions The 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.

目的:从整体上关注北京市综合性公立医院的效率水平及变化,为进一步深化北京公立医院改革并提高医院效率提供参考.方法:基于2012年和2017年《北京市卫生工作统计资料》中北京市二级、三级综合公立医院数据,分别建立Pabon Lasso模型和DEA模型评估其效率水平.结果:北京市2017年三级综合公立医院较2012年BOR、BTO和ALOS指标均有所改善,Pabon Lasso模型中医院效率提高和下降之比为3∶1,DEA综合效率得分在0.8～1的医院增长19.56％.二级综合公立医院仅ALOS指标改善,Pabon Lasso模型中医院效率提高和下降之比为5∶4,DEA综合效率得分在0.8～1的医院增长20.97％.结论:北京市公立综合医院的效率在北京市医改政策推动下有所提升,结合Pabon Lasso模型与DEA模型可提示医院效率改进的有效信息.

BACKGROUNDIn 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.METHODSThe 2011, 2015 and 2018 'Beijing Health Work Statistics' were used to evaluate the performance of Beijing's tertiary public general hospitals, based on the Pabon Lasso model and the data envelopment analysis (DEA) model.RESULTSBased on the Pabon Lasso model, 60%, 70% and 70% of the hospitals were entirely efficient (zone 3) in 2011, 2015 and 2018. It shows that among the 10 general public hospitals in Beijing, efficient hospitals accounted for the majority and further increased during the reform period. The DEA model further illustrates this point and shows more effective hospitals (80%) than the Pabon Lasso model, showing the efficiency of these hospitals to be improved during the reform period.CONCLUSIONSThe efficiency of the 10 hospitals has gradually improved during the reform period, and the difficulty of seeing a doctor in Beijing at a national medical centre has been relieved to a certain extent. Combining the Pabon Lasso model and the DEA model can analyse hospital efficiency more comprehensively, and can prompt initial information for improving hospital efficiency, but the results also reflect some problems.

目的 衡量我国31省市卫生资源配置和卫生服务利用方面的公平性,以实现卫生资源的合理配置,有效满足人们日益增长的卫生服务需求.方法 利用中国国家统计年鉴及卫生和计划生育统计年鉴数据,对卫生资源配置和卫生服务利用进行集中指数的定量分析.结果 2016年我国31省市医疗卫生机构、卫技人员、医疗床位配置的集中指数分别是-0.0869,0.0497和-0.0084;门诊服务利用的集中指数为0.1462,住院服务利用的集中指数为0.0117.1998—2016年集中指数呈现出下降趋势,即卫生资源的配置和利用越来越公平.结论 政府要加强卫生区域规划,合理配置我国地区间卫生资源,加快组建医联体步伐,实现分级诊疗,提高居民卫生服务利用效率.