| 引用本文：代涛,尤川梅,何平.我国公立医院的功能运行状况与改革进展[J].中国卫生政策研究,2009,2(8):14-21 |
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| 我国公立医院的功能运行状况与改革进展 |
| 投稿时间：2009-06-03 修订日期：2009-07-20 PDF全文浏览 HTML全文浏览 |
| 代涛, 尤川梅, 何平 |
| 中国医学科学院卫生政策与管理研究中心 |
| 摘要:经过多年的发展，我国公立医院的服务能力逐步提高，服务功能不断完善，提供了大量的门诊、住院及疑难杂症和危重症诊治服务，承担公共卫生服务、应对突发公共卫生事件、医学教育和科研、对口支援贫困地区基层卫生机构等具有社会功能性质的任务。但我国公立医院在运行中也出现一些问题，如应有的功能和责任履行不到位，布局、规模和结构不尽合理，职工收入与经济效益挂钩，负债经营现象普遍等。为促进我国公立医院良性发展，近年来进行了一系列改革探索，并取得了部分进展，主要包括：1）决策权的变革，主要体现在扩大人员聘用自主权和薪酬分配自主权；2）筹资领域实行融资改革；3）市场环境方面，进行支付方式的改革和对医院支持系统进行社会化改革；4）治理模式改革方面，政府通过任命医院领导团队实施管制；实施新型治理模式的改革，如建立医院管理中心和医院管理理事会，实施“管办分开”等；建立医院集团、推进功能整合等治理模式。 |
| 关键词:公立医院 功能 运行 改革 进展 |
| 基金项目:卫生部政策法规司2008年卫生政策研究立项课题 |
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| An alysis on functional operation and major reform advances of public hospitals in China |
| DAO Tao, YOU Chuan-mei, HE Ping |
| Center for Health Policy and Management, Chinese Academy of Medical Sciences |
| Abstract:After years of development, Chinas public hospitals gained a lot of achievements in improving service ability and functions. The major functions of public hospitals are medical services and social functions, specifically, including providing common outpatient and inpatient services, treating complicated and catastrophic diseases, as well as undertaking social functions, such as, providing public health services, responding to public health emergencies, taking on medical education and scientific research, and assisting primary health care facilities in poor areas. However, there are still some problems in their operation or management, such as insufficient fulfillments of functions and responsibilities, unreasonable configuration, scale and structure, close linkage between health workers incomes and their economic benefits, widespread high liabilities operation models. In order to stimulate the healthy development of public hospitals, many reforms have been implemented in recent years, including: 1）reforming decision making rights, that is, expanding autonomous rights on personnel employment and distribution of remunerations; 2）reforming financing system of public hospital; 3）reforming payment method and supporting system of public hospitals in terms of market environment; and 4）reforming governance models, such as assigning and appointing hospitals managers to strengthen the government regulation, adopting new style of governance models involving in establishing management centers or councils of public hospitals, separating decision making and monitoring functions from enforcing functions of the government, constituting hospital unions and promoting integration of functions, and so on. |
| Key words:Public hospitals, Function, Operation, Reform, Advances |
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