scholarly journals Identifying organisational capability of hospitals amid the new healthcare reform in China: a Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042447
Author(s):  
Jingyu Shi ◽  
Xinyue Sun ◽  
Kai Meng

ObjectiveSince China launched its nationwide systemic healthcare reform in 2009, policies such as the elimination of drug markups and the reform of medical insurance payments have forced some hospitals into a crisis threatening their survival. Both public and private hospitals have been building and strengthening their capacity to achieve sustainable development. However, the existing research has not provided a comprehensive evaluation tool required to support this effort. Therefore, this study develops an organisational capability evaluation index system to help public and private hospitals assess their current conditions.DesignThe Delphi method was used to construct a hospital organisational capability evaluation index system in conjunction with the boundary value method and an analytic hierarchical process. Then, a questionnaire survey was administered in 55 hospitals (32 non-profit and 23 for-profit hospitals), and Cronbach’s α and a factor analysis were used to verify the index system’s reliability and validity.Setting and participantsA literature review and semistructured interviews with 23 hospital managers and scholars clarified the definition of hospital organisational capability and formed an indicator pool. Additionally, 20 hospital directors were selected from public and private hospitals to participate in two rounds of the Delphi consultation.ResultsThe Delphi consultation resulted in an index system including 12 primary and 40 secondary indicators demonstrated to be reliable and valid. The three indicators with the largest weights were ‘regulation capability’ (0.251), ‘decision-making capability’ (0.121) and ‘executive capability’ (0.105).ConclusionThis study constructed an index system based on theoretical and practical considerations, and is expected to be applied to quantitatively evaluate the organisational capability of both public and private hospitals in China, and support their adaptation to external environmental changes.

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Mengdie Xu ◽  
Zhiwei Yang ◽  
Zhiting Li ◽  
Die Liu ◽  
Tan Yang

Background. Organic development is one of the evolutionary development models for cities, and it can facilitate cities to continually adapt to their surroundings and therefore adjust their development. Former research is mostly focused on cities and environmental changes, and research on the organic development of cities in various conditions is rather scarce. Purpose. By creating an evaluation index system for organic cities, this paper has established a multifactor evaluation model and improved the evaluation methodologies for organic cities. Methods. The authors have come up with a method that combines PCA and CNN, established an optimized model to calculate the organic cities, verified the accuracy of the evaluation index system for organic cities, and finally concluded that urban organic development is mostly associated with the aspects of the natural environment, economic basis, land use, and population scale of the city. Case Study. In addition, the examples of Bishan District, Chongqing, and Jiangyin, Jiangsu Province, are simulated and compared, and an accurate prediction for the organic development of small cities in China is given. Conclusion. The evaluation index system for organic cities devised by this paper can be applied effectively to evaluate the organic city of cities, and the neural network prediction model for organic cities designed by this paper can provide references for further research on organic cities.


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