江西省三级甲等综合医院竞争力评价与反馈动态复杂分析
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摘要
健康是人类基本人权的一个重要部分,而医院是治病防病、保障人民健康的卫生医疗机构,是健康产业投资的主体。医院是公益性的服务行业,其宗旨是救死扶伤、普济天下百姓。医疗事业的发展关系到人民群众的切身利益,是社会和谐发展的重要主题。
纵观我国医疗改革的二十多年历程,医疗服务市场竞争是摆在我们面前不争的事实,并呈现出愈演愈烈的趋势。这种竞争强势的冲击迫使各级各类医院,都竭力地在激烈的竞争中培育自己的竞争力。尤其当中国加入WTO后,国内外医疗市场一体化使我国医院所面临的竞争环境越来越严峻,与国外医院相比,我国医院并非缺乏竞争条件和优势,而是缺乏有效竞争力。医院如果没有自身有效的竞争优势,就像没有了持续动力的一艘船,搁浅或沉没则是迟早的事。医院必须迅速、有序地提高竞争力,才能在激烈的医疗市场竞争中求得生存和发展。
然而,医院竞争力问题是一个复杂的系统工程,该问题涵盖了经济学、管理学、系统科学等领域的知识,既是一个社会问题,又是一个经济问题。本论文利用评价理论、竞争力理论、医院管理理论结合具体的医院,找出影响医院竞争力的关键因素,运用系统动力学等理论知识对医院竞争力进行研究,提出具有实际意义的管理对策,不仅能为医院提供新的战略发展方向和多元化经营的新思维,而且能使医院扬长避短,更好地迎接社会大环境的冲击和挑战。
本文的研究工作与主要成果有：
1、构建基于江西省三级甲等综合医院的竞争力评价指标体系。
文章以江西省三级甲等综合医院为研究对象,在对江西省十四所三级甲等综合医院实地调研与系统分析的基础上,详细分析了江西省三级甲等综合医院的现实情况并且运用SWOT工具分别从江西省三级综合医院的优势、劣势、威胁、机遇及组合策略进行了详细分析,并且通过对医院竞争力的影响因素分析,结合江西省三级甲等综合医院的实情从医院的资源能力、临床能力、管理能力三个方面建立了一套具有针对性的、科学的、系统的评价指标体系。
2、基于粗糙集约简理论构建医院竞争力评价模型,算出评价结果,得出医院排名顺序。
论文详细介绍了粗糙集的相关概念与理论,阐述了将粗糙集理论应用于医院竞争力评价的可行性。基于粗糙集的约简方法对医院竞争力评价指标进行了约简,分别得到了医院资源能力、医院临床能力及医院管理能力的关键指标,并利用粗糙集的重要度计算方法算出了这些关键指标的重要度及权重,在此基础上,构建了医院竞争力评价模型,结合综合评价方法得到了江西省十四所三级甲等综合医院的竞争力排序,排序结果符合江西省医院的实情,并将排序结果反馈到江西省相关卫生部门及医院,得到了相关专家的高度评价。
另外,将粗糙集的逻辑推理理论应用于评价系统中进行决策规则的推理应用与研究,其思想仍然是在约简的基础上,提取关键指标,并根据其逻辑推理理论,得到医院竞争力决策规则的推理,降低了因评价医院竞争力指标过多而所需花费的代价,提高了医院竞争力评价的时效性。
3、基于江西省典型医院实地调研分析并构建了具有针对性的九大系统基模。
文章的研究必须将医院的实际与管理理论紧密结合,只有深入具体医院才能准确找出制约医院发展的瓶颈问题,只有将医院的具体问题与管理学中的理论方法、系统方法结合,才能真正找到医院发展的对策与管理方针。为深入了解江西省医院的实情,作者对南昌大学第一附属医院、南昌大学第二附属医院、南昌大学第三附属医院、南昌大学第四附属医院、南昌市第三医院、九江市第一人民医院、九江学院附属医院、九江中医医院、江西省职业病医院、宜春市第一人民医院、新余市人民医院、景德镇市人民医院、赣州市人民医院、赣南附属医院、江西省人民医院、江西武警医院、南昌大学口腔医院、仁爱女子医院等进行为期五个月的实地调研,这些调研的医院中既有三级医院又有二级医院,既有专科医院又有综合医院,既有中医医院又有中西医结合医院,既有公立医院又有私立医院,其用意在于更好地与论文研究的江西省三级甲等综合医院进行综合比较分析,并对调研所得的资料进行整理,借助彼得.圣吉的基模分析技术构建了这些医院实实在在存在的九大系统基模,分别对此进行了定性分析,提出了有针对性的提升医院竞争力的发展策略。
4、基于医院竞争力评价指标体系的SD入树基模生成集法分析。
论文基于医院竞争力评价指标中的二级指标体系,结合系统动力学中的规范建模方法——入树基模生成集法,建立以二级评价指标为主导的九对流位流率系,系统分析各流位之间的相互影响关系,画出九对流位流率系的二部分图,在二部分图的基础上构建九棵SD流率入树模型,定性分析各指标间的反馈动态复杂关系,结合流率基本入树的嵌运算生成极小基模,然后将极小基模按其关键变量进行分类,并结合江西省三级甲等医院的实际情况,构建以关键变量为主导的增长上限反馈基模,然后提出有针对性的促进医院发展的对策。
5、将SD反馈动态复杂分析中的反馈环条数计算方法与计算机知识结合,借助计算机高级编程语言visual c++6.0,实现计算机计算反馈环条数。
反馈环条数的计算是系统动力学中的重要内容,医院竞争力系统是一个由许多反馈环构成的复杂系统,因此,要对此系统进行动态性、复杂性分析,就必须确定其反馈环的集合,这对于结构分析、基模确立、模型调试、结果分析都非常重要。论文将系统动力学反馈动态复杂分析中的反馈环条数计算方法与计算机编程语言结合,创新性地通过计算机高级编程语言visual c++6.0,编写反馈环计算方法的源程序,通过程序的运行,结合论文中医院竞争力系统的研究,实现计算机快速、准确地算出论文中九棵流率入树模型的反馈环总条数,进一步揭示各变量之间的反馈动态复杂关系。
6、基于江西省九江中医医院的系统动力学仿真研究。
论文介绍了系统仿真的定义及仿真方程中流位、流率变量方程；辅助、增补、外生变量方程、内生变量方程；表函数及延迟函数。借助系统动力学仿真研究方法,在对江西省九江中医医院进行全面调研与系统分析的基础上建立了该医院竞争力发展的SD仿真模型,并对每个模型的建立思路进行了阐述,结合医院的实际情况,对模型中各变量建立了各自的数学方程并对各变量进行了定义说明。将仿真模型与仿真方程输入到SD的仿真软件vensim中,进行系统流位变量的仿真结果分析,给出系统仿真趋势图,并结合论文中提出的管理对策,进行方案实施及相关参数调控后得到新的仿真结果,即预测医院采取了相应的措施后的变化趋势,并与原仿真结果进行对比分析,为医院进一步提升竞争力及快速、有序地发展提供了有益的决策依据。
Health is an important part of fundamental human rights. As a main body of a healthy industrial investment, the hospital is the health care institutions that provide treatment and prevention for protecting people's health. Hospital is the public welfare service industry, the purpose is to rescue the wounded and save the people's life. Development of medical services is relative to the interests of the people, at the same time, it is the main topic of the harmonious development of society.
Throughout the 20 years history of health care reform, health care market competition showed a more and more increasingly intense tendency, the situation of sharp competition make most of hospitals try their best to develop their own competitiveness. After the factor-driven or investment-driven, many wise hospital managers are aware that how to foster hospital competitiveness according to the hospital's nature and location. Especially accession to WTO, with the integration of domestic and foreign health care market, which makes our hospitals face increasingly tough competitive environment, compared with foreign hospital, domestic hospital is not lack of competitive conditions and advantages, but lack of effective competitiveness. Any one of hospital does not own competitive advantage, just as a ship that lacking sustained power, will be stranded or sunk sooner or later. Only in a way of improving competitiveness quickly, efficiently and orderly, can hospital survive and develop in a fierce competition of health care.
Hard to see a doctor, high medical cost has become a hot topic. Along with the development trend of economic globalization, China's health care market will be gradually opened to the world,the substance of the competitive market economy is competing for market competition. In particular, with the rapid changes in the medical environment and policy, with the quickly upgrade of medical technology and medical needs, how to enhance hospital competitiveness has become a very important and concerning topic.
However, hospital competitiveness is a complex systematic engineering, which covers economics, management science, systems science and other fields of knowledge, and which is not only a social problem, but also an economic issue. In the thesis, based on evaluation theory, the competitiveness theory, and hospital management theory and combined with some specific hospital, identified the key factors that affect the hospital competitiveness, studied the hospital competitiveness by the method of system dynamics, management statistics and rough set theory. Based on it, put forward practical significance of management measures, which not only provides a new strategic direction and diversification of new thinking for hospitals, but also make hospital better take its advantage and avoid its weaknesses for facing the social environment impact and challenges.
The research achievements in the dissertation are follows:
1. Constructed competitiveness evaluation index system based on the three A-level comprehensive hospitals in Jiangxi province.
The dissertation takes the three A-level hospitals in Jiangxi province as the research object, based on the hospital survey and system analysis about the 14 three A-level hospitals, gave a detailed analysis of the reality of three A-level hospitals in Jiangxi province, by the method of SWOT tool, introduced the strengths, weaknesses, threats, opportunities and portfolio strategy of three A-level hospital. From the analysis of internal and external factors of hospital, the dissertationestablished a set of targeted, scientific and systematic evaluation index system from the resource capacity, clinic capacity and managerial capacity combined with concrete situation of hospital in Jiangxi province.
2. The dissertation proposed a new reduction method and applied it in the research of three A-level comprehensive hospitals in Jiangxi province, obtained the key evaluation index.
The dissertation introduced the concepts of rough set and it's theoretical knowledge, introduced the feasibility of applying the rough set theory in evaluation hospital competitiveness based on being compared with other evaluation methods. On the basis of other reduction method, the author proposed a new reduction method with further studying the reduction method------reduction method of order-cycle column remove based on indiscernibility relation and applied it in the research of three A-level comprehensive hospitals in Jiangxi province, obtained the key evaluation index from the resource capacity, clinic capacity and managerial capacity of hospital, calculated the importance degree and weight of the key indexes, then constructed evaluation model and obtained the ranking of the 14 three A-level hospitals.The ranking result is consistent with the concrete situation of the hospital in Jiangxi province, which is agreeable with some relevant experts. At the same time, the author applied the reasoning of making decision rule of rough set in the evaluation of hospital competitive ability, the idea is that on the basis of reduction to extract key index and obtained the making decision rules according to the theory of the reasoning of rough set, which can decrease the expense of evaluation and simplify the complexity of knowledge base of expert system, and improve the efficiency of evaluation.
3. Accoring to the research in the concrete hospital built nine system archetypes based on the Peter. Senge's archetype analysis technique.
The research must take hospital concrete situation and management theory into account, with doing some survey in the concrete hospital, can accurately identify the specific hospital bottlenecks that restrict hospital development. Only combined the specific problems with the hospital management of the theoretical methods, systemetic methods, can truly find the countermeasures and policy of improving the hospital development. System dynamics (short for SD) approach is an effective way to study complex problems. For better analyzing the competitiveness of three A-level comprehensive hospitals in Jiangxi Province, the study members of hospital competitiveness made lots of specific survey in the 14 three A-level hospitals, three B-level hospitals, two A-level hospitals, two B-level hospitals, private hospitals, Chinese medicine hospitals, Chinese and Western medicine hospitals, some specialist hospitals, and so on. On the basis of Peter Senge's archetype analysis technique, the author collated the information that researched in the hospitals for study of hospital competitiveness for five whole months, built 9 system archetypes of effectively enhancing the public hospital competitiveness, and obtained the targeted strategy after analysis, which provides a theoretical basis for hospitals and hospital management to conduct related research.
4.In-trees archetype generating set analysis based on the hospital competitiveness evaluation index system.
The dissertation built 9 level-rate units and 9 level variable-into-tree models based on the sub-index of hospital competitiveness evaluation index system and standardized modeling method——in-trees archetype generating set method. Then the author qualitatively analyzed feedback dynamics complex relationship between all indexes, with the actual situation of hospital, constructed some typical feedback archetypes, and proposed targeted countermeasures.
5.Combined the feedback loops calculation method of SD with computer knowledge, realized that computer calculate the feedback loops by means of advacnced computer compiling language visual c++6.0.
Determination of the number of feedback loop is the basis of SD model analysis and simulation analysis. Any complex issue in human society is constituted with a lot of balancing feedbacks and reinforcing feedbacks.It is necessary to determine its collection of feedback loops when analyzes the system dynamically,which is very improtant to analyze the structure of this system,establish the archetype,regulate model and simulate. There are many methods to calculate the feedback loop, such as branch vector determinant method and branch vector matrix method. In this dissertation,combined the feedback loops calculation method of SD with computer knowledge, realized that computer calculate the feedback loops by means of advacnced computer compiling language visual c++6.0. Then applied it in the concrete example of the thesis, calculated the feedback numbers of nine level variable-into-tree models through running the program,which further revealed complex dynamic feedback relationship between the variables.
6. On system dynamics simulation research based on Jiujiang Chinese Medicine hospital (short for JJCMH)
In the dissertation firstly introduced the concept of system simulation, level variable equation, rate variable equation, assistance variable equation, added variable equation, exogenous variable equation, endogenous variable, table function and delay function. Based on the investigation and systemic analysis in JJCMH, according to the theory of SD, set up 7 flow-rate-into-tree models, described the idea of model building, defined all variables in the model, and descript its mathematical equations. Then put simulation models and simulation equations into simulation software vensim, analyzed simulation results and simulation charts. Meanwhile, obtained the new simulation charts based on countermeasure implementation and parameter control, which help to compare the new simulation charts with the former simulation charts.
Thanks for funding projects:
1.graduate of innovation special funds in Jiangxi province 2008 (YC08A004):on the research of the hospital competitiveness system evaluation and SD simulation of improving countermeasures——take Jiangxi province as an example.
2. Health Department soft science funds in Jiangxi province 2008.(20082039):on the research of the hospital competitiveness system evaluation and SD simulation of improving countermeasures.
纵观我国医疗改革的二十多年历程,医疗服务市场竞争是摆在我们面前不争的事实,并呈现出愈演愈烈的趋势。这种竞争强势的冲击迫使各级各类医院,都竭力地在激烈的竞争中培育自己的竞争力。尤其当中国加入WTO后,国内外医疗市场一体化使我国医院所面临的竞争环境越来越严峻,与国外医院相比,我国医院并非缺乏竞争条件和优势,而是缺乏有效竞争力。医院如果没有自身有效的竞争优势,就像没有了持续动力的一艘船,搁浅或沉没则是迟早的事。医院必须迅速、有序地提高竞争力,才能在激烈的医疗市场竞争中求得生存和发展。
然而,医院竞争力问题是一个复杂的系统工程,该问题涵盖了经济学、管理学、系统科学等领域的知识,既是一个社会问题,又是一个经济问题。本论文利用评价理论、竞争力理论、医院管理理论结合具体的医院,找出影响医院竞争力的关键因素,运用系统动力学等理论知识对医院竞争力进行研究,提出具有实际意义的管理对策,不仅能为医院提供新的战略发展方向和多元化经营的新思维,而且能使医院扬长避短,更好地迎接社会大环境的冲击和挑战。
本文的研究工作与主要成果有：
1、构建基于江西省三级甲等综合医院的竞争力评价指标体系。
文章以江西省三级甲等综合医院为研究对象,在对江西省十四所三级甲等综合医院实地调研与系统分析的基础上,详细分析了江西省三级甲等综合医院的现实情况并且运用SWOT工具分别从江西省三级综合医院的优势、劣势、威胁、机遇及组合策略进行了详细分析,并且通过对医院竞争力的影响因素分析,结合江西省三级甲等综合医院的实情从医院的资源能力、临床能力、管理能力三个方面建立了一套具有针对性的、科学的、系统的评价指标体系。
2、基于粗糙集约简理论构建医院竞争力评价模型,算出评价结果,得出医院排名顺序。
论文详细介绍了粗糙集的相关概念与理论,阐述了将粗糙集理论应用于医院竞争力评价的可行性。基于粗糙集的约简方法对医院竞争力评价指标进行了约简,分别得到了医院资源能力、医院临床能力及医院管理能力的关键指标,并利用粗糙集的重要度计算方法算出了这些关键指标的重要度及权重,在此基础上,构建了医院竞争力评价模型,结合综合评价方法得到了江西省十四所三级甲等综合医院的竞争力排序,排序结果符合江西省医院的实情,并将排序结果反馈到江西省相关卫生部门及医院,得到了相关专家的高度评价。
另外,将粗糙集的逻辑推理理论应用于评价系统中进行决策规则的推理应用与研究,其思想仍然是在约简的基础上,提取关键指标,并根据其逻辑推理理论,得到医院竞争力决策规则的推理,降低了因评价医院竞争力指标过多而所需花费的代价,提高了医院竞争力评价的时效性。
3、基于江西省典型医院实地调研分析并构建了具有针对性的九大系统基模。
文章的研究必须将医院的实际与管理理论紧密结合,只有深入具体医院才能准确找出制约医院发展的瓶颈问题,只有将医院的具体问题与管理学中的理论方法、系统方法结合,才能真正找到医院发展的对策与管理方针。为深入了解江西省医院的实情,作者对南昌大学第一附属医院、南昌大学第二附属医院、南昌大学第三附属医院、南昌大学第四附属医院、南昌市第三医院、九江市第一人民医院、九江学院附属医院、九江中医医院、江西省职业病医院、宜春市第一人民医院、新余市人民医院、景德镇市人民医院、赣州市人民医院、赣南附属医院、江西省人民医院、江西武警医院、南昌大学口腔医院、仁爱女子医院等进行为期五个月的实地调研,这些调研的医院中既有三级医院又有二级医院,既有专科医院又有综合医院,既有中医医院又有中西医结合医院,既有公立医院又有私立医院,其用意在于更好地与论文研究的江西省三级甲等综合医院进行综合比较分析,并对调研所得的资料进行整理,借助彼得.圣吉的基模分析技术构建了这些医院实实在在存在的九大系统基模,分别对此进行了定性分析,提出了有针对性的提升医院竞争力的发展策略。
4、基于医院竞争力评价指标体系的SD入树基模生成集法分析。
论文基于医院竞争力评价指标中的二级指标体系,结合系统动力学中的规范建模方法——入树基模生成集法,建立以二级评价指标为主导的九对流位流率系,系统分析各流位之间的相互影响关系,画出九对流位流率系的二部分图,在二部分图的基础上构建九棵SD流率入树模型,定性分析各指标间的反馈动态复杂关系,结合流率基本入树的嵌运算生成极小基模,然后将极小基模按其关键变量进行分类,并结合江西省三级甲等医院的实际情况,构建以关键变量为主导的增长上限反馈基模,然后提出有针对性的促进医院发展的对策。
5、将SD反馈动态复杂分析中的反馈环条数计算方法与计算机知识结合,借助计算机高级编程语言visual c++6.0,实现计算机计算反馈环条数。
反馈环条数的计算是系统动力学中的重要内容,医院竞争力系统是一个由许多反馈环构成的复杂系统,因此,要对此系统进行动态性、复杂性分析,就必须确定其反馈环的集合,这对于结构分析、基模确立、模型调试、结果分析都非常重要。论文将系统动力学反馈动态复杂分析中的反馈环条数计算方法与计算机编程语言结合,创新性地通过计算机高级编程语言visual c++6.0,编写反馈环计算方法的源程序,通过程序的运行,结合论文中医院竞争力系统的研究,实现计算机快速、准确地算出论文中九棵流率入树模型的反馈环总条数,进一步揭示各变量之间的反馈动态复杂关系。
6、基于江西省九江中医医院的系统动力学仿真研究。
论文介绍了系统仿真的定义及仿真方程中流位、流率变量方程；辅助、增补、外生变量方程、内生变量方程；表函数及延迟函数。借助系统动力学仿真研究方法,在对江西省九江中医医院进行全面调研与系统分析的基础上建立了该医院竞争力发展的SD仿真模型,并对每个模型的建立思路进行了阐述,结合医院的实际情况,对模型中各变量建立了各自的数学方程并对各变量进行了定义说明。将仿真模型与仿真方程输入到SD的仿真软件vensim中,进行系统流位变量的仿真结果分析,给出系统仿真趋势图,并结合论文中提出的管理对策,进行方案实施及相关参数调控后得到新的仿真结果,即预测医院采取了相应的措施后的变化趋势,并与原仿真结果进行对比分析,为医院进一步提升竞争力及快速、有序地发展提供了有益的决策依据。
Health is an important part of fundamental human rights. As a main body of a healthy industrial investment, the hospital is the health care institutions that provide treatment and prevention for protecting people's health. Hospital is the public welfare service industry, the purpose is to rescue the wounded and save the people's life. Development of medical services is relative to the interests of the people, at the same time, it is the main topic of the harmonious development of society.
Throughout the 20 years history of health care reform, health care market competition showed a more and more increasingly intense tendency, the situation of sharp competition make most of hospitals try their best to develop their own competitiveness. After the factor-driven or investment-driven, many wise hospital managers are aware that how to foster hospital competitiveness according to the hospital's nature and location. Especially accession to WTO, with the integration of domestic and foreign health care market, which makes our hospitals face increasingly tough competitive environment, compared with foreign hospital, domestic hospital is not lack of competitive conditions and advantages, but lack of effective competitiveness. Any one of hospital does not own competitive advantage, just as a ship that lacking sustained power, will be stranded or sunk sooner or later. Only in a way of improving competitiveness quickly, efficiently and orderly, can hospital survive and develop in a fierce competition of health care.
Hard to see a doctor, high medical cost has become a hot topic. Along with the development trend of economic globalization, China's health care market will be gradually opened to the world,the substance of the competitive market economy is competing for market competition. In particular, with the rapid changes in the medical environment and policy, with the quickly upgrade of medical technology and medical needs, how to enhance hospital competitiveness has become a very important and concerning topic.
However, hospital competitiveness is a complex systematic engineering, which covers economics, management science, systems science and other fields of knowledge, and which is not only a social problem, but also an economic issue. In the thesis, based on evaluation theory, the competitiveness theory, and hospital management theory and combined with some specific hospital, identified the key factors that affect the hospital competitiveness, studied the hospital competitiveness by the method of system dynamics, management statistics and rough set theory. Based on it, put forward practical significance of management measures, which not only provides a new strategic direction and diversification of new thinking for hospitals, but also make hospital better take its advantage and avoid its weaknesses for facing the social environment impact and challenges.
The research achievements in the dissertation are follows:
1. Constructed competitiveness evaluation index system based on the three A-level comprehensive hospitals in Jiangxi province.
The dissertation takes the three A-level hospitals in Jiangxi province as the research object, based on the hospital survey and system analysis about the 14 three A-level hospitals, gave a detailed analysis of the reality of three A-level hospitals in Jiangxi province, by the method of SWOT tool, introduced the strengths, weaknesses, threats, opportunities and portfolio strategy of three A-level hospital. From the analysis of internal and external factors of hospital, the dissertationestablished a set of targeted, scientific and systematic evaluation index system from the resource capacity, clinic capacity and managerial capacity combined with concrete situation of hospital in Jiangxi province.
2. The dissertation proposed a new reduction method and applied it in the research of three A-level comprehensive hospitals in Jiangxi province, obtained the key evaluation index.
The dissertation introduced the concepts of rough set and it's theoretical knowledge, introduced the feasibility of applying the rough set theory in evaluation hospital competitiveness based on being compared with other evaluation methods. On the basis of other reduction method, the author proposed a new reduction method with further studying the reduction method------reduction method of order-cycle column remove based on indiscernibility relation and applied it in the research of three A-level comprehensive hospitals in Jiangxi province, obtained the key evaluation index from the resource capacity, clinic capacity and managerial capacity of hospital, calculated the importance degree and weight of the key indexes, then constructed evaluation model and obtained the ranking of the 14 three A-level hospitals.The ranking result is consistent with the concrete situation of the hospital in Jiangxi province, which is agreeable with some relevant experts. At the same time, the author applied the reasoning of making decision rule of rough set in the evaluation of hospital competitive ability, the idea is that on the basis of reduction to extract key index and obtained the making decision rules according to the theory of the reasoning of rough set, which can decrease the expense of evaluation and simplify the complexity of knowledge base of expert system, and improve the efficiency of evaluation.
3. Accoring to the research in the concrete hospital built nine system archetypes based on the Peter. Senge's archetype analysis technique.
The research must take hospital concrete situation and management theory into account, with doing some survey in the concrete hospital, can accurately identify the specific hospital bottlenecks that restrict hospital development. Only combined the specific problems with the hospital management of the theoretical methods, systemetic methods, can truly find the countermeasures and policy of improving the hospital development. System dynamics (short for SD) approach is an effective way to study complex problems. For better analyzing the competitiveness of three A-level comprehensive hospitals in Jiangxi Province, the study members of hospital competitiveness made lots of specific survey in the 14 three A-level hospitals, three B-level hospitals, two A-level hospitals, two B-level hospitals, private hospitals, Chinese medicine hospitals, Chinese and Western medicine hospitals, some specialist hospitals, and so on. On the basis of Peter Senge's archetype analysis technique, the author collated the information that researched in the hospitals for study of hospital competitiveness for five whole months, built 9 system archetypes of effectively enhancing the public hospital competitiveness, and obtained the targeted strategy after analysis, which provides a theoretical basis for hospitals and hospital management to conduct related research.
4.In-trees archetype generating set analysis based on the hospital competitiveness evaluation index system.
The dissertation built 9 level-rate units and 9 level variable-into-tree models based on the sub-index of hospital competitiveness evaluation index system and standardized modeling method——in-trees archetype generating set method. Then the author qualitatively analyzed feedback dynamics complex relationship between all indexes, with the actual situation of hospital, constructed some typical feedback archetypes, and proposed targeted countermeasures.
5.Combined the feedback loops calculation method of SD with computer knowledge, realized that computer calculate the feedback loops by means of advacnced computer compiling language visual c++6.0.
Determination of the number of feedback loop is the basis of SD model analysis and simulation analysis. Any complex issue in human society is constituted with a lot of balancing feedbacks and reinforcing feedbacks.It is necessary to determine its collection of feedback loops when analyzes the system dynamically,which is very improtant to analyze the structure of this system,establish the archetype,regulate model and simulate. There are many methods to calculate the feedback loop, such as branch vector determinant method and branch vector matrix method. In this dissertation,combined the feedback loops calculation method of SD with computer knowledge, realized that computer calculate the feedback loops by means of advacnced computer compiling language visual c++6.0. Then applied it in the concrete example of the thesis, calculated the feedback numbers of nine level variable-into-tree models through running the program,which further revealed complex dynamic feedback relationship between the variables.
6. On system dynamics simulation research based on Jiujiang Chinese Medicine hospital (short for JJCMH)
In the dissertation firstly introduced the concept of system simulation, level variable equation, rate variable equation, assistance variable equation, added variable equation, exogenous variable equation, endogenous variable, table function and delay function. Based on the investigation and systemic analysis in JJCMH, according to the theory of SD, set up 7 flow-rate-into-tree models, described the idea of model building, defined all variables in the model, and descript its mathematical equations. Then put simulation models and simulation equations into simulation software vensim, analyzed simulation results and simulation charts. Meanwhile, obtained the new simulation charts based on countermeasure implementation and parameter control, which help to compare the new simulation charts with the former simulation charts.
Thanks for funding projects:
1.graduate of innovation special funds in Jiangxi province 2008 (YC08A004):on the research of the hospital competitiveness system evaluation and SD simulation of improving countermeasures——take Jiangxi province as an example.
2. Health Department soft science funds in Jiangxi province 2008.(20082039):on the research of the hospital competitiveness system evaluation and SD simulation of improving countermeasures.
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