ABSTRACT
Objective:
To analyze the impact created by the reallocation of a
tertiary hospital on the
neurosurgery inpatients volume in the functional core area of
Beijing as the
capital city, for reference to improve the
healthcare resource reallocation
policy.
Methods:
The data were obtained from the data sheet of discharged
patients and the monthly
report of medical
statistics in
Beijing. The study analyzed the average monthly
neurosurgery inpatients volume, surgical
beds and
bed utilization rate of
secondary or higher level
hospitals from the core area, a
tertiary hospital(
hospital A), and as well as three
tertiary hospitals(
hospitals B, C and D)within 5 kilometers of
Hospital A original
location before and after the reallocation of Hospitls A. Periods of November 2017 to August 2018 and November 2018 to August 2019 respectively serve as the
time frame before and after the relocation of
Hospital A.
Results:
After the reallocation, the average monthly total
inpatients volume,
inpatients volume from other places, and local
inpatients volume of
neurosurgery at
secondary or higher level
hospitals in the core area decreased from 2 238, 1 610 and 628 to 1 526, 996 and 530 respectively. The
inpatients volume changes were all statistically different( P<0.001). The number of
neurosurgery inpatients in
Hospital A and
Hospital B increased from 983 and 659 to 1 316 and 934 respectively, as well as the number of
neurosurgery inpatients in
Hospital C and
Hospital D did not change much. After the relocation of
Hospital A, the number of surgical
beds in
secondary or higher level
hospitals in the core area was reduced from 5 213 to 4 782, while that of
Hospital A increased from 557 to 750, while the other three
tertiary hospitals remained unchanged. The changes of
bed utilization rate of the 4 hosptials were all less than 7.00%.
Conclusions:
After the reallocation
Hospital A, the
neurosurgery inpatient volume in the core area decreased, which was mainly contributed by the decrease of
patients from other places, suggesting a positive outcome by the reallocation of
healthcare resources in
Beijing. On the other
hand, it is necessary to study the influence of alternative medical
resources on the reallocation effect.