医改对医疗服务业绩效的影响研究

发布时间：2018-04-07 19:08

本文选题：医疗改革　切入点：绩效　出处：《浙江工商大学》2012年硕士论文

【摘要】：医疗卫生关系我们身心健康,同时也关系我国经济发展的人力资本投入。从改革开放到现在,伴随经济改革的浪潮,医疗卫生事业也经历了几次改革。由于医疗市场的特殊性,使市场的作用在医疗卫生领域失灵,同时政府在医疗领域管制的不到位,医疗服务市场疗服务供给的公平性下降和补偿机制的扭曲等问题滋生出“以药养医,以检查养医,以设备养医”等现象,至使医疗费用的快速增长,“看病难,看病贵”成为突出的社会问题,加重了社会和个人的经济负担。与此相关的是医疗事故不断发生,医患关系开始紧张。在我国医疗市场上,公立医院是医疗市场的供给主体,其医疗费用的控制对整体医疗费用起关键性作用。伴随医疗卫生领域的放开,民营医院加大了对医疗卫生领域的投资,这一方面增加供给,促进市场竞争,提高了行业绩效,但另一方面也暴露出一些问题,如医疗事故频发,医疗质量参差不齐,也加大了公众的负担。世界各国围绕医疗费用问题对整个医疗服务体系实施改革。在其改革的过程中,往往会暴露出医疗费用下降的同时,而医疗质量也下降的问题。 2005年7月,国务院发展研究中心课题组在《对中国医疗卫生体制改革的评价与建议》的报告中得到的医疗体制“改革基本上是不成功”的总体评价后,新一轮的医改拉开了帷幕,经过多方多次的研究讨论,2009年4月公布新医改方案《中共中央国务院关于深化医药卫生体制改革的意见》。新医改方案确立了政府主导的基本原则,明确提出要“强化政府在基本医疗卫生制度中的责任”。本文首先从所有权理论和竞争理论上探讨影响医疗费用和医疗质量的因素,其中,重点阐述所有权安排对于医疗费用控制和医疗质量的影响,市场竞争对于医疗费用控制和医疗质量的作用,并且对医改对医疗服务行业绩效的影响进行分析。对中国现阶段医疗服务市场的改革,分析现阶段医疗市场的所有权格局与竞争格局,提出中国新一轮医疗卫生体制改革,应该进一步对公立医院进行改革,调动各类资源的积极性,降低医疗费用,提高医疗服务质量。应进一步扩大民营资本市场准入的范围,鼓励各种社会资本参与投资的营利性和非营利性医疗机构的发展,促使整个医疗服务市场开展健康有序地竞争,提高医疗服务业的绩效水平。
[Abstract]:Health care is related to our physical and mental health, but also to our economic development of human capital investment.Since the reform and opening up to the present, along with the wave of economic reform, the medical and health industry has also experienced several reforms.Due to the particularity of the medical market, the role of the market in the field of medical and health services has failed, and the government has failed to regulate the medical field.The decline in the fairness of medical service supply in the medical service market and the distortion of the compensation mechanism have led to the phenomenon of "keeping doctors with drugs, checking them, and raising doctors with equipment." this has led to a rapid increase in medical costs, and "it is difficult to see a doctor."Expensive medical treatment "has become a prominent social problem, increasing the social and personal economic burden."Related to this is the continuous occurrence of medical accidents, the relationship between doctors and patients began to tense.In the medical market of our country, the public hospital is the main body of the medical market, and the control of its medical expenses plays a key role in the overall medical cost.With the opening of the medical and health field, private hospitals have increased their investment in the field of medical and health care. On the one hand, they increase supply, promote market competition, and improve the performance of the industry, but on the other hand, they also expose some problems, such as the frequent occurrence of medical accidents.The uneven quality of medical care has also increased the burden on the public.Countries around the world around the issue of medical costs to implement the reform of the entire medical service system.In the course of its reform, it often exposes the decline of medical cost and the decline of medical quality.In July 2005, the research group of the Development Research Center of the State Council obtained an overall evaluation of the medical system "basically unsuccessful" in its report "Evaluation and recommendations on the Reform of China's Medical and Health system".A new round of medical reform was launched. After many studies and discussions, the new medical reform plan "opinions of the CPC Central Committee and the State Council on deepening the Reform of the Medical and Health system" was published in April 2009.The new medical reform scheme establishes the basic principle of government leading, and clearly proposes to "strengthen the responsibility of the government in the basic medical and health care system".This paper first discusses the factors that affect medical expenses and medical quality from ownership theory and competition theory. Among them, it focuses on the influence of ownership arrangement on medical cost control and medical quality.The effect of market competition on medical cost control and medical quality, and the impact of medical reform on medical service industry performance are analyzed.On the reform of the medical service market in China at present, the ownership and competition pattern of the current medical market is analyzed, and the new round of medical and health system reform in China is put forward, which should be further reformed to the public hospitals.Mobilize the enthusiasm of all kinds of resources, reduce medical costs, improve the quality of medical services.The scope of market access for private capital should be further expanded, and all kinds of social capital should be encouraged to participate in the development of for-profit and non-profit medical institutions, so as to promote healthy and orderly competition in the entire medical service market.Improve the performance of the medical service industry.
【学位授予单位】：浙江工商大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R197.1;F719

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