国内现有公立医院管办分离改革模式研究初探

发布时间：2018-01-22 21:32

本文关键词： 公立医院管办分离政府职能政府治理系统　出处：《云南大学》2014年硕士论文　论文类型：学位论文

【摘要】：管办分离已成为国际主流的公立医院改革方向,国内外有关实践经验层出不穷,然而不同的地域由于政治经济条件不同,具体的改革经验存在较大的差异,但试点城市的改革经验仍是推进我国公立医院管办分离改革的重要经验参考。改革过程中,要及时回顾和反思改革目标,才能牢牢把握住改革方向,避免在改革目标上出现偏差。随着国内改革试点城市涌现出来的各种管办分离经验来看,人们对于公立医院管办分离的认识和理解也呈现多样化,这无疑是不利于后续具体政策制定和执行的。同时,管办分离概念的模糊也加大了改革在全国范围内进行推广的难度。目前我国尚未建立起对公立医院管办分离改革进行研究的理论框架,具体改革措施的设计和决策缺乏系统性,对改革试点的研究较为零散且在推广层面上局限性较大。从经济学角度来对公立医院管理体制改革进行思考,其本质是提高提供特殊服务性质的卫生组织的供给效率及组织运行效率,因此从最基本的供需关系为入手,发现目前公立医院管理体制存在问题主要是由于传统的管办合一下的一系列问题与不断提高的公民对基本医疗卫生服务需求间的矛盾,由此确定本文的研究对象——公立医院管办分离管理模式。本文通过对文献资料的整理分析,对公立医院管办分离的研究现状有了一个大致的了解,厘清我国公立医院管办分离改革产生的原因和管办分离的内涵；明确了改革深入过程中公立医院管理体系自身和其系统环境中存在的问题。然后通过对国内现有的典型改革经验进行对比分析和参考借鉴发达国家的先进经验,针对管理体系存在的问题以及系统环境的阻力提出针对性的政策建议。
[Abstract]:Management separation has become the international mainstream of the reform of public hospitals, domestic and foreign experience in practice emerge one after another, but different regions due to different political and economic conditions, the specific experience of reform has great differences. However, the reform experience of the pilot cities is still an important reference to promote the reform of the separation of public hospitals and offices. In the process of reform, we must review and reflect on the reform objectives in order to firmly grasp the direction of reform. To avoid the deviation in the reform goal. With the emergence of a variety of management and separation experience in the pilot cities of domestic reform, people's understanding of the separation of public hospitals is also diversified. At the same time, the ambiguity of the concept of management separation also increases the difficulty of popularizing the reform in the whole country. At present, China has not established a theoretical framework for the research on the reform of separation of management and office in public hospitals, and the design and decision-making of specific reform measures are lacking in a systematic manner. The research on the pilot reform is scattered and limited in the aspect of popularization. From the angle of economics, the author thinks about the reform of the management system of public hospitals. Its essence is to improve the supply efficiency and organization operation efficiency of WHO, which provides special services, so it starts with the most basic supply and demand relationship. It is found that the existing problems in the management system of public hospitals are mainly due to the contradiction between the traditional management system and the increasing needs of citizens for basic medical and health services. From this, determine the object of this study-public hospital management separation management model. Based on the analysis of the literature, this paper has a general understanding of the current research situation of the separation of management and office in public hospitals, and clarifies the causes of the reform and the connotation of the separation of management and office in public hospitals in China. The problems of the public hospital management system and its system environment in the deep process of reform are clarified. Then through the comparative analysis of the existing typical reform experience and the reference to the advanced experience of the developed countries. Aiming at the problems existing in the management system and the resistance of the system environment, this paper puts forward some relevant policy suggestions.
【学位授予单位】：云南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.3

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