| 引用本文：黄菊.院长最关注的改革重点：基于三级公立医院的调查[J].中国卫生政策研究,2017,10(11):41-45 |
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| 院长最关注的改革重点：基于三级公立医院的调查 |
| 投稿时间：2017-07-10 修订日期：2017-08-15 PDF全文浏览 HTML全文浏览 |
| 黄菊 |
| 中国医学科学院医学信息研究所 北京 100020 |
| 摘要:目的：了解我国大型公立医院院长对公立医院改革主要措施的关注情况及态度。方法：随机抽取200名三级公立医院院长进行横断面调查。结果：公立医院院长最关注的问题是增加政府投入（83.7%），对推行临床路径关注比例最低（19.7%）。院长认为政府平均投入应占医院总收入的50.8%，且55.1%的院长认为政府应该按项目对公立医院进行投入。82.0%的院长认为收入未提高是影响医务人员参与医院改革积极性的主要因素，并且仅14.5%的院长对自己目前的收入水平是满意的。结论：三级公立医院院长最关注医院运营相关的改革措施，其次是薪酬制度和院长责权改革。因此，公立医院改革应建立科学合理的医疗服务价格体系以及长效的政府投入机制。建立符合医疗行业特点的岗位绩效薪酬制度，调动医务人员积极性。明确院长责权，落实公立医院经营管理自主权。 |
| 关键词:公立医院改革 院长 横断面调查 |
| 基金项目:协和青年基金资助和中央高校基本科研业务费项目（33320140089） |
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| The key point of public hospital reform: Based on the investigation and research of public hospital presidents |
| HUANG Ju |
| Institute of Medical Information, Chinese Academy of Medical Scienceses, Beijing 100020, China |
| Abstract:Objective:To understand the concerns and attitudes of large public hospital presidents in China towards the main hospital reform measures. Methods:A cross-sectional survey was conducted on 200 randomly selected third-class public hospital presidents to learn the managers' perspectives on public hospital reform. Results:The most concerned problem for public hospital presidents was increasing government investment, and the number of followers accounted for 83.7%; the least concerned problem for public hospital presidents was implementing clinical pathway, and the number of followers accounted for only 19.7%. The hospital presidents believed that the government investment should account for 50.8% of the total hospital income, and 55.1% of the hospital presidents thought that the government should invest in public hospitals in the way of project investment. 82.0% of the hospital presidents assumed that the lack of increase in income was the main factor affecting the active participation of medical staff in hospital reform, and only 14.5% hospital presidents were satisfied with their current income level. Conclusion:The presidents of tertiary public hospitals are most concerned with the reform measures related to the operation of hospital. The hospital presidents are were also concerned about the compensation system reform, and the reform on responsibility and rights of hospital presidents. Therefore, public hospital reform should establish a scientific and rational medical service price system and a long-term government investment mechanism, and establish a job performance based compensation system to mobilize the enthusiasm of medical personnel of medical industry, and clarify the power and responsibility of hospital presidents, and the implementation of public hospital management autonomy. |
| Key words:Public hospitals reform President Cross-sectional survey |
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