Under the cold winter of the epidemic, hospitals still have to rely on "hard work" to survive.
Written by | Yao Yuan
Source | "Medical think tank" public number
"Closed-loop management, the larger the hospital, the more difficult it is to bear." Professor Guo Hui, dean of Shanghai Deji Hospital/Shanghai Brain Medicine Center of Qingdao University, told the "think tank of the medical community".
At the beginning of this month, Shanghai Deji Hospital received a notice from the superior epidemic prevention and entered a 7-day closed-loop management. Compared with the previous two-week and 14-day closed-loop management cycle, the time experienced by the hospital has been greatly shortened, but the blow to the hospital is still very heavy, "I don't know how long it will take to digest the impact of this time." ”
Only 2 years ago, this well-known large-scale brain hospital was the first and only social medical rescue team in Shanghai to aid Wuhan, and it also carried a month and a half of medical supplies with the car, worth more than 4.5 million, which was reported by CCTV "News Network", Oriental Satellite TV and other major media.
More than 1,000 people were in the hospital, and non-emergency surgeries were stopped
On March 6, Shanghai Deji Hospital received a notice from the superior to cooperate with the investigation, and the whole hospital immediately entered the closed-loop management. It turned out that a patient who was diagnosed positive for COVID-19 on March 3 said that he had visited a friend who was hospitalized in Deji at noon on February 27, during which he briefly removed his mask.
President Guo Hui said that after receiving the notice from the superior, more than 1,000 people in the hospital, including medical care and patients, were all isolated on the spot, and only entered and could not leave. At the same time, all employees who returned home 4 days ago must be summoned back to the hospital for isolation and observation. "If the rescue patient comes, it is okay to save lives, and other non-life-saving surgeries are not allowed to do." We, the hospital leaders, did not dare to go home, and slept in the office, for fear of being sealed in the home of the residential community. ”
During the closed-loop management period, nucleic acid testing in the whole hospital needs to be carried out on the 1st, 2nd, 4th, 7th and 14th days respectively, and this part of the work is also digested by the hospital.
Deji Hospital, which has entered a closed-loop management state, not only needs to monitor the health of more than 1,000 hospital personnel in the hospital, but also conducts multiple rounds of nucleic acid testing for all employees. At the same time, so many patients and families are stranded in the hospital, and the problem of eating must be solved by the hospital's ideas. "This is a very big challenge for any hospital." Guo Hui said frankly.
For every day of the shutdown, it loses nearly 4 million
When receiving the prevention and control order from the superior, Guo Hui asked how many days of closed-loop management was needed? The answers were inconsistent. "At first, it was closed for 7 days, 14 days, and then the door was opened for 7 days."
In the days of waiting for the unsealing, Guo Hui waited very anxiously. He has calculated an account, the hospital usually has an outpatient volume of 1500-1600 person-times, and all the controls are zeroed. The hospital has 350 beds, and the average daily cost alone is nearly 2 million. In addition, during the closed-loop management of the hospital, nucleic acid testing and internal killing are also carried out, and this part of the personnel cost and material procurement cost all need to be paid by the hospital itself, and there is no additional subsidy.
"There is no penny of income, but all the expenditure is still there, and the investment is still increasing, because you still have to fight the epidemic and eliminate the epidemic, and the labor cost cannot be reduced." Guo Hui said frankly that even a week after the unsealing, the hospital was still greatly affected, and many patients still did not dare to come. "If you really want to count, one in and one out will exceed 4 million a day." Such a loss is unbearable for any hospital.
In the traditional impression, the larger the hospital, the stronger the ability to resist blows, but non-public medical treatment is just the opposite. Guo Hui explained to the "medical think tank" that like beauty hospitals and high-end confinement clubs are still good, especially small hospitals have low costs, basically it is closed on holiday, the rest is only rent, people are few, said to close the door to close. "We can't do this, [the patients] have just finished surgery, and there are hospitalized patients, critically ill patients, (even if the door is closed and closed-loop management) can't stop."
According to public information, Shanghai Deji Hospital was founded in 2013, is a "strong specialty small comprehensive" hospital built according to the scale of tertiary first-class specialized hospitals, focusing on clinical neurology (brain), almost all department directors are "post-70s, doctoral graduates, large-scale tertiary hospital experts", in 2020 was rated as the first batch of industry evaluation AAA credit hospitals and five-star hospitals with capacity evaluation in Shanghai, and is the only one in Shanghai that has established a teaching system for training from undergraduate to graduate students. A teaching hospital that recruits master's degree students from the state.
Non-public medical treatment under the epidemic situation is competing with the foundation of disciplines
Since 2019, the new crown epidemic has been raging for nearly 3 years, and the cold winter facing non-public medical care is extremely long, and cash flow is undoubtedly the sword of Damocles hanging in the hearts of hospital administrators.
Once the cash flow is broken, the hospital is not far from closing, which is a common situation faced by non-public medical institutions, but at the same time, its financing channels are very limited. Guo Hui said that in addition to relying on its own reserves and bank loans, non-public medical care can also rely on financial means, such as financial leasing and equity financing. "(But) the big hospitals are financing from bank loans, and now the cost of financial leasing channels is very high." Worried about diluting the founder's equity, the veteran of the social medical office replied concisely and without the slightest hesitation: "You have to live, otherwise you can't live, why are you still holding that equity?" ”
In him, there is both the courage to break the boat and the determination of careful analysis, and he firmly believes that he can lead the hospital through the current stage. In his view, it is now time to compete with hospitals to accumulate discipline thickness - hospitals that usually pay attention to discipline team building and specialty characteristics, and have accumulated a good reputation, there will be pressure to close for a short time. But once it opens, there will still be many patients from all over the country. "These are still hard work, in the usual accumulation and management, if you usually rely on the dispensing of drugs (hospitals), basically can not survive." Our Epilepsy Center of Tokuji Hospital surpasses Shizuoka National Epilepsy Hospital in Japan, is the largest in Asia, we took the lead in introducing the first neurosurgical robot in Shanghai and six provinces in East China, the surgical treatment of spinal cord tumors and brain tumors, and the national stroke center for cerebrovascular diseases, which are also located in the first ranks in China. We have full confidence to overcome difficulties and provide high-level medical treatment to patients across the country. ”
For the future, Guo Hui is still optimistic: "I estimate that Shanghai (in the face of this wave of epidemics) will insist on another month and a half months, just like (20) 20 years, at most 2 months, And Wuhan will fight the epidemic for 2 months." ”
Reader comments
@Dr. Smile: Very realistic. Under the epidemic situation, the social medical office has been called to stop at all times, which is indeed passive. Shenzhen Futian social medical institutions have been suspended for nearly a month, and there is no time line for resuming work.
@ Xu Xming: Private hospitals have no financial subsidies, operating costs are high, the days are more difficult, and this year will fall a batch
@仵X红: For the prevention and control of the epidemic and the health of the people, even if it is a loss, we must persist!
@ Tao X Yun: At least in the foreseeable three or five years, private hospitals are still very difficult, regardless of the formation and stability of personnel teams, discipline positioning and development, the equality and continuity of government policies, enjoy less than 10% of the financial subsidies of public hospitals, land and electricity, etc., especially the media, government departments management and social public opinion guidance need to be strengthened!
Expert Profiles
Hui Guo, MD, Chief Physician, Professor Neurosurgery Specialist, former Assistant Professor of New York University Medical Center, specializes in the surgical treatment of refractory epilepsy, leading the team to build the largest epilepsy center in Asia. Shortlisted for the nomination of "Top Ten Doctors" in Shanghai, he was awarded the 2021 Shanghai Health System Advanced Worker and the Shanghai United Front Advanced Individual. President of Shanghai Deji Hospital/Shanghai Brain Medicine Center of Qingdao University. Deputy Secretary-General of the Medical Branch of the Shanghai European and American Returned Scholars Association (Shanghai Federation of Overseas Chinese), Member of the Standing Committee of the Chinese People's Political Consultative Conference.