公立医院“管办分离”的逻辑与实践:法人治理视角被引量：9

The Logic and Practice of "Separation of Management and Operation"in Public Hospitals:Perspective of Corpor ate Governance

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摘要公立医院"管办分离"的目的在于确立其不同于政府行政法人的地位与性质,并在此基础上赋予其与政府平等契约的身份以获得经营自主性。"管办分离"能否实现取决于契约之后的剩余权状态,如果剩余权得以对应并从政府下移到医疗机构则能形成有利于"管办分离"的法人治理结构。医管中心设置于体制内的做法并没有形成剩余索取权与剩余控制权的对应关系,如果将医院管理功能设置于体制外,其功能发挥的程度关联着医疗机构法人治理中的理事会成员参与治理的动力。联合体形式比单一公立医院有着更为分化的内部单元,因而有更为强烈的利益诉求表达,更容易形成有效的法人治理结构,但深入看公立医院法人治理的有效性归根结底取决于政府层层责任机制的完善。 The purpose of "separation of management from running" in public medical institutions is to establish its status and nature different from that of government administrative legal persons, and on this basis to give it the status of equal contract with the government to obtain business autonomy. The realization of "separation of management from running" depends on the state of residual right after the contract, and if the residual right can be corresponding and moved from the government to the medical institution, it can form a corporate governance structure conducive to "separation of management from running ". The establishment of the medical management center in the system does not form the corresponding relationship between the residual claim right and the residual control right. If the hospital management function is set outside the state system, the degree of its function is related to the motivation of the board members in the corporate governance of medical institutions to participate in the governance. The form of association has a more differentiated internal unit than a single public hospital, so it has a stronger expression of interest demands, and it is easier to form an effective corporate governance structure. However, the effectiveness of corporate governance in public medical institutions depends on the perfection of government responsibility mechanism.

作者吴素雄沈信姿董建新杨华 Wu Suxiong;Shen Xinzi;Dong Jianxin;Yang Hua(School of Public Health and Management,Wenzhou Medical University,Wenzhou 325035;School of Marxism,Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053)

机构地区温州医科大学公共卫生与管理学院湖州师范大学医学院温州医科大学浙江中医药大学马克思主义学院

出处《浙江社会科学》 CSSCI 北大核心 2020年第8期53-61,157,共10页 Zhejiang Social Sciences

基金国家社科基金重点项目《社区公共卫生服务集团化供给的关系结构与治理研究》(批准号:17AZZ011)阶段性成果。

关键词医管中心管办分离法人治理剩余索取权剩余控制权 medical management center separation of management from running corporate governance residual claim residual control right

分类号 R197.32 [医药卫生—卫生事业管理]