| 引用本文：张静, 王虎峰, 郭冰清.如何解释公立医院综合改革政策执行的不平衡性？——基于EICPHR评价体系的案例研究[J].中国卫生政策研究,2019,12(4):27-34 |
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| 如何解释公立医院综合改革政策执行的不平衡性？——基于EICPHR评价体系的案例研究 |
| 投稿时间：2019-01-29 修订日期：2019-03-15 PDF全文浏览 HTML全文浏览 |
| 张静1,2, 王虎峰2,3, 郭冰清2,3 |
1. 国家神经系统疾病临床医学研究中心(首都医科大学附属北京天坛医院) 北京 100070;
2. 中国人民大学医改研究中心 北京 100872;
3. 中国人民大学公共管理学院 北京 100872 |
| 摘要:为了科学解释各地公立医院综合改革在政策执行中存在的问题以及政策执行不平衡的原因，本研究引入EICPHR评价体系，从变革力、可持续性和变革力组合三个角度对4个县域公立医院综合改革案例进行评价分析，得出的结论是：优良的政策设计是基础，而执行是关键；一旦政策推开，消除政策执行的不平衡即是落实政策的关键。在几种改革模式中， “高驱动力—低制约力”是最佳组合，也是改革成功的重要经验。据此提出以下政策建议：一是改革既要增加驱动，更要化解阻力；二是选择试点和示范的原则应是既要驱动到位，更要化解阻力有方。三是做好变革—再冻结的衔接，建立健全现代医院管理制度；四是建立更加科学的改革评价和监督制度，考核评价应反映被评价对象的内在运行的规律。 |
| 关键词:公立医院综合改革 政策执行 案例研究 |
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| How to interpret the imbalance in implementing public hospitals' comprehensive reform policies:A case study based on the EICPHR evaluation system |
| ZHANG Jing1,2, WANG Hu-feng2,3, GUO Bing-qing2,3 |
1. China National Clinical Research Center for Neurological Diseases(Beijing Tiantan Hospital, Capital Medical University), Beijing 100070, China;
2. School of Public Administration and Policy, Renmin University of China, Beijing 100872, China;
3. Institute of Hospital Management, Renmin University of China, Beijing 100872, China |
| Abstract:In order to scientifically elucidate the challengesin the implementation of public hospitals' comprehensive reform policies in various regionsand figure out the reasons of the existing imbalance, this study uses the EICPHR evaluation system to analysis 4 county-level public hospital reforms from three differential perspectives, namely transformational force, sustainability, and change forces combination. The results show that, roll out the policies with the goal to eliminating the imbalance of performing, a good policy design is the foundation and a good implementation is the key in eliminating the imbalance of policy implementation. Among several reform models, the "high driving force-low restraining force" model is identified as the best combination and key experience for achieving the reform success. Drawn by the finding, this paper puts forward four policy suggestions. First, the reform should not only increase the driving force, but also meliorate the restraining force. Second, the principle of selecting the pilot location and illustrate examples is the best way to keep the driving and restraining forces balanced. Third, a smooth connection between change and refreeze facilitates a healthy development of modern hospital management. Fourth, it is necessary to establish a more scientific reform evaluation and supervision system to effectively control any potential risks. |
| Key words:Public hospital reform Policy implementation Case study |
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