Hospital management strategy is the vision and task of the hospital. The core of hospital management strategy is resource allocation. By planning and studying the future resource allocation and its interaction with the external environment, all important problems in hospital management and development can be guided and solved. It is necessary for a hospital to establish a strategic management system, so as to take advantage of the opportunities it faces and avoid the threats it receives, and at the same time, turn the weaknesses within the hospital into advantages. The strategic management system can solve the problems of market share, market complexity, fixed assets scale, market growth rate, competition degree and environmental change degree. After China's entry into WTO and the opening of the medical market, the state encouraged more private and foreign investors to invest in hospitals, and the market competition became more intense. At the same time, if the open economy wants to participate in global competition, it will inevitably create a complex operating environment for hospitals, and decision makers no longer have enough information on environmental factors, so it is difficult to predict the changes in the external environment. The uncertainty, complexity and variability of this environment also increase the difficulty of hospital decision-making
Second, the hospital external environmental factors analysis?
(1) Changes in the medical consumption market: With the opening of the medical market, consumers' views on medical consumption have changed. Maintaining and establishing trust and cooperation with consumers has become the most important and effective competitive advantage of hospitals. From the perspective of starting the medical insurance system in China, the control of the medical expenses of the insured has obviously increased. By determining the personal burden of the insured, the excessive demand of the demander can be suppressed, the cost inflation can be controlled, and the insured can be guided to seek medical treatment. Great changes have taken place in the external environment of hospitals. The obvious sign of change is that medical expenses are restricted by doctors or hospitals and become restricted by payers. In other words, the medical market has changed from a bilateral relationship between hospitals and patients to a tripartite relationship between hospitals and patients, the government and medical insurance companies. In this way, hospitals are in a special supply and demand market environment among patients, medical insurance companies and the government.
(2) Consumer research: Due to the constant changes of customers' consumption level and behavior, they pay more attention to the quality and price of medical consumption.
1. Overall characteristics of consumers: With the improvement of residents' living standards, people pay more and more attention to service quality, which is conducive to stimulating consumption growth. With the improvement of wealth, people pay more attention to the value of time. According to the survey, the improvement of service level, rapid availability and high convenience of services have become more important. People are more willing to pay more for quality service than before, as long as it can bring convenience.
2. Research on consumers' medical consumption behavior: A questionnaire survey was conducted on consumers' intention to choose a hospital for medical treatment. 500 questionnaires were distributed and 489 were recovered. The main factors considered in the survey include price, brand awareness, convenience, service quality and environment. The survey results show (Figure 1): When consumers choose a hospital for medical treatment, the first consideration is the price factor, accounting for 96.1%; Secondly, the service quality accounts for 83.6%; Brand awareness accounts for 55.8%; Convenient medical treatment accounted for 32.5%; Environmental comfort accounted for 27.6%.
(3) Market supply and demand: Since the reform and opening up in China, the health industry has made great progress. However, at present, the supply and demand in the medical care market are still unbalanced, and there are still defects in the supply chain such as supply structure, supply mode and supply quality, and the demand for medical care consumption is seriously lagging behind. The reason comes from supply and demand. On the supply side, since 1990s, China's health investment accounts for about 4% of the gross domestic product (GDP), while the average level of OEcD countries is above 7%, and the United States reaches 12.6%. And because of the unbalanced economic development between regions in China, the uneven distribution of health investment between urban and rural areas and between regions, the shortage of medical supply is more prominent. From the demand level, the most direct and basic medical demand comes from residents' families. At present, China's residents' savings have exceeded 5 trillion yuan, and the medical expenditure prepared by residents' savings accounts for 8%. Especially the medical care of some wealthy families is not only the need of survival, but also the enjoyment of longevity, health and happiness. Not long ago, Beijing Zero Company conducted a survey in five major cities, including Beijing, Shanghai and Guangzhou. The greatest happiness of residents in their life is health (76.40%), full life (44.50%), affluence (30.24%) and enterprising (19.79%). It shows that health has become the biggest goal pursued by residents.
(4) Analysis of the external environment of the hospital:
1. Economic factors: Economic factors are potential factors that directly affect various business strategies. China's national economy maintained a good development momentum at 200 1. The state has adopted proactive fiscal and monetary policies, increased the scale of investment, and strengthened the scale of investment in fixed assets, which has played a stimulating role in GDP. The wages of employees in government agencies and institutions and pensions for retirees have all increased. China continued to introduce a series of reform measures such as increasing income, expanding domestic demand and starting consumption, which effectively boosted consumption growth. From the perspective of consumer investors, among the eight categories of consumer spending, food, clothing, use, medical care, transportation and entertainment have increased simultaneously.
2. Political, government and legal factors: Political, government and legal factors have brought important opportunities and threats to large and small enterprises. In recent years, the reform measures of medical system introduced by the state include: implementing government-guided prices and market-regulated prices for medical services, and canceling government pricing; Implement separate accounting and management of drugs, standardize the scope and methods of financial subsidies, and adopt two-line management methods for hospital drug revenue and expenditure; Classify hospitals, distinguish for-profit hospitals from non-profit hospitals, clearly divide the business purposes and service tasks of two different medical institutions, and implement different financial, tax, price policies and financial accounting systems.
3. Social, cultural, demographic and environmental factors: Where is the hospital?
Directly related to it. In economically rich and developed areas, people's living standards are constantly improving, and people's demand for medical care is also increasing. 2 1 century, some infectious diseases will show a sustained high incidence rate, and old and new infectious diseases will still pose a serious threat to global health; By 2002, chronic non-communicable diseases will become the main cause of death, disease and disability in the world. Aging and urbanization have become the trend of global population development, and aging leads to the increase of chronic non-communicable diseases, disabilities and mental diseases; The change of population structure will make medical care an important consumption of products and services; The speed of urbanization exceeds the capacity of health infrastructure to meet people's health needs. Overcrowding and bad working environment lead to anxiety, depression and long-term tension, which adversely affects the quality of life of families and communities.
4. Technical factors: Revolutionary technological progress is having a great impact on hospitals, including biotechnology, superconductivity, laser, cloning and so on. With the deepening of China's medical and health reform, the competition among hospitals is becoming more and more fierce, and many hospitals are constantly developing new technologies and projects to win competitive advantages. At the same time, in the new economic information era, scientific and technological information is developing rapidly. Whoever can take the lead in the same scientific and technological achievements will seize the lead and pose a threat to others.
Third, competitive factors.
(A) hospital competitive environment:
Figure 2 is a "hospital competitive strategy chart", which illustrates all aspects of hospital competitive strategy and explains how hospitals participate in competition and its specific economic goals. Hub is the general goal of the hospital, that is, how to compete and its specific economic and non-economic goals. Spokes are business strategies used to achieve these goals.
Due to the uncertainty of the operating environment, it will have many different effects on the hospital. As a starting point, first consider what environmental factors the hospital is affected by, and consider the degree of change of the importance of these factors to the hospital and its future competitors.
(B) Hospital operating environment: Porter put forward the viewpoint of industry competition and industry competition strategy, which provided a strong theoretical basis for the analysis of the competitive environment in the industry. The profitability of a hospital depends on its ability to cope with external influences, and fundamentally depends on the interaction of five structural factors. Using Porter's five strength model to evaluate these factors can help us analyze the competitive environment of the medical industry and formulate a competitive strategy that conforms to the characteristics of the hospital (Figure 3). The competitive state in an industry depends on five basic competitive forces, which jointly determine the ultimate profit potential of the industry. This profit potential is measured by long-term investment return, and the final profit potential will change fundamentally with the change of this resultant force. The goal of hospital competitive strategy is to make the hospital in the best position in the medical industry and resist or influence five competitive forces. Because the resultant force of the five forces is obvious to all competitors, it is very important to analyze the source of competitive pressure after going deep into the superficial phenomenon. Knowing the source of stress can analyze the opportunities and threats faced by hospitals. The environmental pressures faced by hospitals come from: first, the medical and health reform, and the government has changed from controlling quasi-human behavior to advocating the use of private capital or foreign capital to set up hospitals, especially after joining WTO. Second, in the face of the continuous development of community medical care and individual clinics, some patients are lost after the medical market segmentation, and the distribution path is generated by itself. Thirdly, due to the influence of price and demand, buyers have opened up the medical market, chosen more hospitals and have strong bargaining power. However, there are many suppliers of medical equipment and drugs, and competitive bidding directly affects the cost, which is easy to obtain and the bargaining power of suppliers is low. Fourth, there is fierce competition for equipment and talents in the medical market. The application of new technology affects cost positioning and product quality, and new competitors directly affect price and market share.
(3) competitor analysis: determine the weight of key factors that affect competitiveness through expert investigation, and the sum of all factors' weights must be equal to L. Then compare the scores between hospitals, with the range of 1 ~ 4, where "4" stands for strong competitiveness, "3" stands for second strong competitiveness, "2" stands for second weak competitiveness, and "1" stands for weak competitiveness. Multiply the weight of each factor by its score to get the weighted score of each factor. Finally, add all the weighted scores to get the total weighted score of each hospital. Judging from the matrix of competitive situation (table 1), the total score of competitor 1 is 2.8, which shows the hospital with the strongest comprehensive competitiveness. However, just because competitor 1 has a total score of 2.8 in the competitive situation matrix and a total score of 2.3 in the evaluation hospital, it cannot be considered that competitor 1 is 20% stronger than the evaluation hospital. Figures reflect the relative advantages of hospitals, but on the surface, their accuracy will bring illusion. The figures are only the information of the evaluation survey to help this research make strategic decisions. Table 1 competitive situation matrix Note: The score value indicates: 1: weak, 2: sub-weak, 3= sub-strong, 4= strong. Competitor 1 scored 2.8, indicating that he is the strongest.
Fourth, the opportunities and threats faced by hospitals.
The factors that affect the hospital management strategy include national policy, economy, social culture, science and technology, etc. With the reform of China's medical system, hospitals with different systems, such as Sino-foreign joint ventures and Sino-foreign cooperation, will bring new impacts to China's medical market with completely different business concepts and management models. After a series of medical reform measures centered on classified management reform of medical institutions are fully implemented, hospitals will adjust their business strategies and management systems according to changes in their internal and external environments. Coupled with the personnel system reform to be implemented in China, the all-round competition among hospitals including talents, technology and services will be further intensified. These factors not only bring good opportunities to hospitals, but also bring severe challenges, mainly reflected in the fierce competition in the medical market, the government's opening of the medical market, and the construction of private and joint-venture hospitals; Implement a tax policy for for-profit hospitals; In the bilateral agreement between China and the United States, the location of medical insurance is not restricted by region, and the insurance business is not restricted. Through the above analysis, the influence of the external environment on the hospital includes economy, politics, law, society, culture, population, technology and competition, so as to identify the opportunities and threats formed by the external environment of the hospital. Opportunities brought by the external environment: first, the people's living standards have improved, and the demand for medical and health care has increased day by day; Second, demographic changes and social aging have brought huge potential medical market; Third, the change of consumers' medical consumption concept; Fourth, for-profit hospitals can adjust their own charging prices and so on. At the same time, the change of environment also brings certain risks to hospitals: First, the quasi-human behavior in the medical market is relaxed, and the government advocates the use of private capital or foreign capital to set up hospitals, so many new entrants may pose a threat; Second, in the face of the continuous development of community medical care and individual clinics, some patients are lost after the medical market segmentation; Third, the fierce competition for medical technical talents leads to brain drain; Fourth, competitors are getting stronger and stronger; Fifth, for-profit hospitals implement tax policies and so on.
Verb (abbreviation of verb) strategic choice
(1) scale management strategy? 1: scale operation is to successfully achieve low-cost expansion, seize more and larger markets, and have strong market competitiveness. The benefits of scale operation can form a loose combination of hospital or medical group, chain operation and various cooperation modes through joint merger and asset reorganization, and the result is bound to expand the new medical market, promote the utilization efficiency of regional health resources, and give play to the benefits of hospital scale operation. Scale operation, opportunities and risks coexist. In order to prevent the expansion from failing or carrying a heavy burden, the scale effect grasps the direction and object of expansion. First, choose the correct expansion direction, realize leap-forward development, and focus on the domestic and international medical market after China's entry into WTO; Second, choose the right time to expand. From the analysis of the internal advantages of the hospital, we can see that the comprehensive strength and economic foundation of the hospital have developed to a certain stage and are fully equipped with the strength of expansion; Third, choose the appropriate expansion target, and don't carry out small and featureless hospitals in a narrow area. We should inspect the hospitals to be merged and analyze the feasibility of expansion on the basis of careful market research. Fourth, actively and steadily achieve low-cost expansion, and do a good job in the property rights system, personnel system and distribution system.
(2) Differentiated management strategy: Patients in the hospital not only hope to get fast, safe and effective treatment, but also hope to get care and love from medical staff. With the improvement of living standards, I also hope to enjoy convenient and comfortable medical services. Therefore, service quality and medical quality are two internal and inseparable parts of hospital work quality. Hospitals should establish their own unique service strategies. Especially in today's medical technology specialty, high service quality and community service, the differences mainly come from the differences in resources and capabilities, among which the most important differences are organizational resources, human resources and intangible assets.
(3) Brand management strategy-2J: The adoption of brand strategy is to create a unique service model for hospitals that is in line with the market and suitable for patients, so as to ensure the sustainable development of hospital competitiveness. Because in the consumer market, brand awareness is getting stronger and stronger in consumers' minds, once consumers form "consumer satisfaction" in the medical services provided by hospitals, they will often establish long-term and good medical supply and demand cooperation with hospitals. In addition to the inherent technical content, product quality and price, the brand of hospital should also have intangible assets formed by experts' popularity, professional characteristics, sophisticated instruments and technical level, including high social credibility, high experts' popularity and good reputation among the people. In the medical market, whoever can solve patients' problems well and has the core technology with competitive advantage will gain the trust of patients, and with the trust of patients, the hospital will develop. Hospitals without discipline advantages and their own characteristics and brands are not competitive in the medical market. Brand formation often takes a long time. For a hospital, there is only one way to form a brand, that is, relying on continuous innovation, turning to high technology, seeking space in innovation, establishing the core technology of the hospital through innovation, and establishing the hospital brand 2.
(4) High-quality management strategy Patients will choose hospitals according to the quality of medical care. Facing the increasing medical demand and the emergence of quality concept, medical quality management must be in line with international standards in order to win in the medical market competition after death. Mainly from the following three aspects: first, attach importance to the international standards of quality management; Second, attach importance to the role of ecological culture in hospital construction; The third is to pay attention to the improvement of service level.
(V) Characteristic business strategy: those who have no self have original technology, those who have me have excellent technology, and those who have me have excellent technology. It is these technologies that constitute characteristic management, and technical characteristics are the core of effective competitiveness. The basis of implementing characteristic management is that "the institute has key disciplines and specialties, and people have technical expertise". The development of technological characteristics depends on technological innovation, which depends on high-quality talents, who need working conditions such as equipment and funds to complete innovation. Therefore, the characteristic management strategy emphasizes characteristics and innovation, which actually embodies the core competitiveness of hospitals. The essence of innovation is to create the first, that is, to occupy medical care.
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