摘要
2009年启动的新一轮医药卫生体制改革取得了明显进展,但核心任务之一的公立医院改革相对滞后。一方面,受新公共管理理论影响,广义的公立医院可以视为由不同社会主体举办、为社会公众利益服务而设立和运营的非营利性医疗服务机构。另一方面,国际公共服务发展趋势显示,公共产品和服务并不一定必须由政府提供,非政府组织提供公共产品和服务的效率可能更高。因此,从公平竞争的角度,可以借鉴政府购买服务的管理模式来推进传统公立医院的改革。从中国的政府购买卫生服务实践看,还存在对供方监管不到位、服务内容不科学、评价体系不健全、支付方式不合理等问题。在借鉴国际经验的基础上,作者认为应当转变政府对现有公立医院的投入方式,建立完善政府购买卫生服务机制,从明确服务内容、规范预算管理、建立薪酬制度、加强绩效考核、推进信息公开、研究公立医院改制等方面提出了建议。
The new round of medical and health system reform started from 2009 had made significant progress. However, the public hospital reform, one of the core tasks, was lagging behind. On the one hand. public hospitals in a broad sense could be regard- ed as non-profit medical service institutions organized by different social subjects were established and operated for social common in- terests according to the new public management theory. On the other hand, the development trend of international public service showed that public products and services were not necessarily to be provided by the government. It was more efficient for non-govern- mental organizations provide public products and services. Therefore. from the perspective of equal competition, the experiences of government＇s purchasing service management model could be learned to promote the reform of traditional public hospitals. Reviewing the Chinese government＇s purchasing health service practice, there were still some problems such as lacking supervision of the suppli- er, the unscientific service content, imperfect evaluation system and unreasonable payment method. In reference on the basis of international experience, it needed to change the government＇s investment method for the existing public： hospital, establish and improve the mechanism of government＇s purchasing health service. It provided suggestion on some aspects such as explicit the service con- tent, regular the budget management, establish the salary system, strengthen the performance evaluation, promote the intormation dis- closure and analyze the restructuring of publie hospitals.
出处
《中国卫生经济》
北大核心
2016年第9期19-21,共3页
Chinese Health Economics
关键词
政府购买服务
公立医院改革
绩效评价
government purchasing service
public hospital reform
performance evaluation
