Hospital System In Post Epidemic Era: Public Funds Under Pressure Private Hospitals Or Life And Death Tests

"The Spring Festival holiday is also suffering from a new crown pneumonia epidemic. The performance of the first two months is definitely gone, plus the stoppage of surgery, and not many hospitalized in March." A staff member of a third class hospital in Guangzhou regrets the twenty-first Century economic report.

In the first March of 2020, due to the spread of the new crown pneumonia epidemic, most of the business windows were shut down. Both public and private hospitals were faced with financial pressure of one kind or another.

Recently, Aili, Guangzhou, a famous third party hospital management consulting organization, launched a survey of hospital operations. The 316 questionnaires covered 26 provinces, including 204 public hospitals, 112 social medical hospitals, 63.92% of three hospitals. The survey showed that the volume of business and revenue in all the hospitals surveyed declined in the same period in February of 2020. Of these, 99.37% of the hospitals had a decline in the number of outpatient visits, 100% of the hospital's hospitalization and operation volume declined, and the hospitalization and operation volume declined most severely.

According to the survey, in February, the number of outpatient clinics dropped by more than 40%, accounting for 78.48%, while the number of hospitals falling by 30%-40% was 11.39%, while that of less than 10% hospitals accounted for only 1.9%. In February this year, the number of hospitalized hospitals declined by more than 50% compared with 58.86%, with a decrease of 40%-50% of 15.82% and a decrease of less than 20% of hospitals accounted for only 6.33%. In terms of operation volume, the proportion of hospitals falling more than 60% is 56.33%, the proportion of hospitals falling by 50%-60% is 14.56%, and that of hospitals below 30% is 8.86%.

"Both public hospitals and social medical hospitals are facing the pressure of funds in the post epidemic era. The epidemic began at the end of December last year. Most public hospitals and social medical hospitals do not choose to keep a large amount of cash at the end of the year as the operating expenses for the next year. Usually, they will not exceed the fixed cost of the first quarter of next year. However, during the epidemic period, the income of the hospital itself will drop significantly, and the expenditure will also be greatly improved. For example, the cost of protective clothing and disinfectant will lead to the hospital's existing funds being difficult to support the normal operation of the hospital. Zhuang Yiqiang, director of Guangzhou Aili hospital management research center, told reporters on twenty-first Century economic report.

Examination of cash flow in public and private hospitals

The outbreak of new crown pneumonia has been more than 2 months old, and all walks of life have been affected to varying degrees. Although the domestic epidemic has gradually stabilized, various industries have begun to resume work, but the epidemic crisis has not yet been completely ended. The adverse effects on many industries are not yet fully resolved at one thirty, and the medical industry is even more serious. Survey data show that 90% hospitals now have financial pressure, and the situation of private hospitals is more difficult. The cash flow support of nearly 60% private hospitals is less than 2 months. The expenditure of 55.1% of the surveyed hospitals increased in February compared with the same period last year, and 44.9% of the hospitals in February decreased year by year.

In the proportion of manpower cost to total hospital cost, before the epidemic, the proportion of manpower cost in the total cost of 53.5% hospitals was between 30%-40%, and only 8.9% of hospitals accounted for more than 50% of the total. After the outbreak, the proportion of human cost increased significantly, and the proportion of human cost in the proportion of 40%-50% increased to 15.9% from 15.9% before the epidemic. The proportion rose from 8.9% before the epidemic to 32.3%, indicating that the cost of human labor during the epidemic period has become the major expenditure of most hospitals and the largest expenditure on hospital cash flow pressure.

94.1% of the hospitals experienced a year-on-year decline in cash flow during the epidemic, of which 76.6% of hospitals fell by more than 20%, while 15.6% of hospitals fell between 10%-20% and only 4.5% of hospitals did not have any impact. 88.6% of the hospitals had financial pressure, accounting for 21.7% of the hospitals which had a lot of pressure. The hospital accounted for 36.3% of the total pressure. The hospital with a certain pressure accounted for 30.6%.

In addition, the survey shows that 50% of hospitals have insufficient funds to support for 2 months, of which 24.4% of hospitals have only one month to support their funds. Among them, cash flow in public hospitals can support less than 2 months, accounting for 45.1% of the proportion of public hospitals. The cash flow of social medical hospitals can support 57.1% of the surveyed social hospitals. The results showed that the cash flow pressure of social hospitals during the epidemic period was even greater.

On the supplementary sources of short-term funds, the survey shows that 31% of the hospitals in the public hospitals can receive financial subsidies during the epidemic period, 27% of the public hospitals have bank loan channels, and 16% of the public hospitals can make credit or financing to suppliers. 14% of public hospitals have no short-term funding sources.

In the social medical hospitals, 29% of hospitals do not have short-term funding sources, 23% of them can get bank loans, and 9% of hospitals can get additional investments from investors. The survey results show that the social medical hospitals have more capital channels than the public hospitals in terms of short-term funds supplement, and the ability to resist risks in the face of outbreaks is also lower.

The survey shows that for hospitals, the biggest pressure from the next six months to a year comes from the recovery of business, especially the recovery of hospitalization. This proportion accounts for 38.61% of the questionnaire, followed by financial pressure, and 34.81% of hospitals think that the financial pressure is the biggest pressure in the next six months to a year.

After the epidemic, most of the hospitals hoped for support this year, 79.11% of the hospitals hoped that the government could give financial subsidies to the hospitals, 67.72% of the hospitals hoped that the medical insurance could provide support, and 53.16% of the hospitals hoped that the government would give preferential policies to finance and taxation.

In addition, affected by the epidemic, most hospitals have chosen the computer and Internet technology to optimize the operation mode. 55.06% of the hospitals choose to expand to the online diagnosis and treatment. 55.7% of the hospitals choose to invest more in the field of artificial intelligence (AI) and distant medical services in the future. At the same time, the hospital hopes that the relevant supporting measures will be more perfect. Strong, for example, 58.86% of the surveyed hospitals hope that online medical insurance reimbursement can be realized at an early date. It is believed that in the near future, with the gradual development of relevant supporting policies and measures, the speed of "Internet" and "intellectualization" of hospitals will be accelerated.

In addition, the epidemic led to a cold winter in the national hospital industry. For doctors, it is difficult for patients to improve their level and even have a negative impact on the clinical professional level of doctors, and the clinical business of doctors will have a certain impact on the results of scientific research projects.

Speed up social office shuffle

And the number of private hospitals is the most severe.

Since February, most hospitals have closed general out-patient clinics, and small medical institutions such as private clinics are simply not allowed to open doors, which will undoubtedly have a huge impact on the income of medical institutions. Despite the fact that medical institutions have begun to resume work, many private medical institutions are still afraid or unable to start business. In many areas, medical beauty, stomatology and other specialized medical institutions are still on the list of restrictions on re employment, and even some areas require private dental clinics to give every patient a new crown pneumonia nucleic acid test, which is in disguised form to close the door to resume work. In addition, there are still a large number of organizations that are not allowed to open because they do not meet the requirements of epidemic prevention.

"For hospitals, public hospitals and social medical hospitals need to wake up to reflect on emergencies. And public health emergencies may exist in the respiratory tract, gastrointestinal tract, nervous system and other fields. In view of public emergencies, hospitals need to have a new thinking of combining peacetime and wartime. Specifically, for example, young specialists can choose a major specialist direction and a secondary specialist direction, for example, an anesthesiology doctor can help minor disciplines, such as the ICU department, and conduct wartime coordination when necessary. In addition, public hospitals have a certain system, large system and small system circulation system, and the future hospital system needs to be changed, such as layering, registration, payment, treatment, etc. small circulation can reduce the possibility of nosocomial infection. In terms of the major cycle, cross infection can be reduced, such as the distinction between internal medicine building, surgical building and inspection building. And ward isolation and other measures also need to continue to upgrade adjustment. Zhuang Yiqiang analyzed.

Under the impact of the epidemic, the withdrawal of the capital also has a certain impact on the private medical system.

"At present, there are two kinds of investment providers in the community. Financial investors and strategic investors, such as Phoenix medical and Fosun medical care, are strategic investments. Their medical treatment and investment in medical care may have little impact, but there will be a round of exit for financial investors. From the perspective of earning money, investment hospitals will inevitably lead to a certain degree of ebb, which can be understood as an epidemic in general. The private hospital system is speeding up to shuffle, but in the long run, there is still room for long-term development. Zhuang Yiqiang told the twenty-first Century economic news reporter.

In February 26th, medical investor Lin Jianhua launched the activities of "joint listing companies, industrial funds and medical groups to acquire various medical institutions". According to incomplete statistics, up to now, nearly 50 medical institutions have intention to transfer. Among them, there are 11 medical beauty, 10 oral, 9 Ophthalmology, 5 Chinese medicine, 4 pediatric, 3 general hospitals, 3 maternity hospitals, 3 Department of orthopedics hospitals, 3 rehabilitation hospitals, and nursing homes and medical care combined with 4 families. The target area is located in the first tier cities, such as Hangzhou, Nanjing, Chengdu, Chongqing and Xiamen.

Under such a "protracted war", how to survive is a realistic problem faced by a large number of medical institutions. Although the "public" and "private" are facing the problem of insufficient capital reserves, it is obvious that the situation of private medical institutions is more dangerous and even a test of life and death.

Compared with public hospitals, the funds for social medical services are even more scarce, and the ability to resist risks in the face of outbreaks is even lower. If medical services fail to recover, there may be more private medical institutions that have been dragged down.

In the past, private hospitals showed a specialized mode of light assets, mainly in Ophthalmology, Department of Dermatology, infertility and so on, and relatively low risk resistance, while private hospitals invested in light assets and concentrated on some light asset subjects, thus leading to the closure of some disciplines, but there was room for maneuver in comprehensive hospitals, so the development direction of private hospitals was also facing more challenges.

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