HUANG Yi , LIN Li , ZENG Yulong , ZHU Yi , FEI Yanghua , FU Xiaoying
  • Finance Department, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
LIN Li, Email: 49872133@qq.com
Public hospital; economic operation; Deyang; root cause analysis
10.7507/1002-0179.202512242
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Objective  To analyze the changing trends of economic operation indicators in public hospitals in Deyang City, explore the root causes of increasing operational pressure, and propose targeted countermeasures and suggestions. Methods  Based on the annual health financial reports of 23 public hospitals in Deyang City from 2016 to 2024, the Joinpoint regression model was used to analyze the time-series trends of 20 economic operation indicators (covering four dimensions: revenue, operational efficiency, cost control and surplus capacity, and debt-paying ability). The annual percent change (APC) was calculated, and important turning points were identified. Meanwhile, a root cause analysis team was established. Fishbone diagram was used to analyze proximal causes from five aspects (man, machine, material, method, and environment), and the “5WHY method” was applied to trace the root causes. Results  Among the 20 indicators, 6 showed significant changing trends. Total medical revenue continued to grow, but the growth rate slowed markedly after 2019 (P=0.035, APC decreased from 10.66 to 4.58). The average length of stay for discharged patients showed a trend of first increasing and then decreasing, with 2020 as the turning point (P<0.001, APC changed from 2.42 to ?4.79). The average medical cost per discharged patient shifted from growth to decline in 2020 (P<0.001, APC changed from 9.34 to ?4.57). Total medical activity costs continued to grow, and although the growth rate slowed after 2019 (P=0.027, APC decreased from 11.35 to 5.30), it remained higher than that of total medical revenue. The proportion of personnel expenses continued to grow, tending to flatten after 2018 (P=0.019, APC decreased from 3.91 to 0.79). Health materials consumed per 100 yuan of medical revenue first increased and then decreased, with 2022 as the turning point (P=0.008, APC changed from 1.90 to ?5.44). Root cause analysis showed that the root causes of increasing operational pressure were lack of overall planning for regional healthcare institutions, inadequate internal management level of medical institutions, revenue pressure brought by medical insurance fund management and payment reform, and defects in the medical service price adjustment mechanism that failed to fully reflect true value. Conclusion  It is recommended that health authorities strengthen regional overall planning and functional positioning of medical institutions, medical institutions promote refined management and disease-based cost control, medical insurance departments improve the coordinated use and settlement mechanisms of insurance funds, and incorporate cost factors into the pricing mechanism and improve the dynamic adjustment mechanism.

Citation： HUANG Yi, LIN Li, ZENG Yulong, ZHU Yi, FEI Yanghua, FU Xiaoying. Changing trends and root cause analysis of economic operation indicators of public hospitals in Deyang. West China Medical Journal, 2026, 41(7): 1161-1167. doi: 10.7507/1002-0179.202512242 Copy

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