新医改背景下我国公立医院改革研究
发布时间：2019-05-12 03:51
【摘要】：改革开放以来，我国经济高速发展，，人均收入水平显著提高。伴随而来的是我国的经济发展方式也在实现着新阶段的跨越，已经从单纯的追求经济总量和发展速度转向追求总量、质量的同步提升，实现经济又快又好发展。 随着生活水平的提高，对于当代公共服务的数量和质量，人民群众的要求也越来越高,人本价值也成为了人民思考的主要问题。越来越多的关注焦点放到了生活质量和与自身密切相关的民生问题，这其中尤为突出的是医疗卫生。 “看病难、看病贵”问题一直是我国的热点问题。人民群众要求的不仅仅是不断增加的卫生资源总量,我们更关心的是公平与效率。我国目前的公共医疗服务主要是通过公立医院提供的，公立医院是政府实现基本公共服务均等化的重要战略举措之一。然而，公立医院公益性的目标，单靠市场化的运作难以实现，需要国家给予财政方面的支持。 2009年4月,国务院公布了《中共中央国务院关于深化医药卫生体制改革的意见》。一定程度上推进了我国的公立医院改革的步伐。公立医院也逐步回归到公益性的道路上。 然而，我国公立医院仍然存在着政府责任缺失问题。具体表现为：政府责任定位模糊；公益性越来越淡化；政府财政投入不足且经费使用效率低；缺乏科学有效的补偿机制。如没有统一的补偿标准、补偿方式单一、支付控费手段欠缺；公立医院布局不合理；政府对公立医院监管不到位等。新医改背景下，公立医院改革必须充分发挥政府的主导作用。 本文以政府责任视角研究新医改背景下我国公立医院的改革。开篇先对文章的研究背景做了阐述，并通过整合国内外的研究文献，归纳总结了国内外学者的研究现状。接下来，对公立医院改革的政府职责进行理论基础上的分析，并对公立医院相关概念、市场与政府职责的内容进行界定。 再者，从我国医改过程中政府责任演化历程和财政支持公立医院模式的变化两个方面，纵向分析中国公立医院改革中政府责任的变化。由此引出我国现阶段存在的政府责任缺失问题。再通过对政府责任缺失问题的具体分析，指出政府支持公立医院改革的必要性和现实紧迫性。接下来，分析总结国外政府支持公立医院的经验和启示、以及我国子长县公立医院试点改革经验。本文的最后，提出我国政府支持公立医院的相关政策建议。
[Abstract]:Since the reform and opening up, China's economy has developed at a high speed and its per capita income has increased significantly. Along with it, the mode of economic development of our country is also realizing the leapfrogging of the new stage, which has changed from the simple pursuit of the total economic quantity and the speed of development to the pursuit of the total amount, the synchronous improvement of the quality, and the realization of the rapid and good development of the economy. With the improvement of living standards, the requirements of the people are getting higher and higher for the quantity and quality of contemporary public services, and the people-oriented value has become the main problem that the people think about. More and more attention has been paid to the quality of life and the livelihood issues closely related to themselves, especially medical and health care. The problem of "difficult to see a doctor, expensive to see a doctor" has always been a hot issue in our country. What the people are asking for is not only the increasing total amount of health resources, but also the fairness and efficiency. At present, the public medical service in our country is mainly provided through the public hospital, which is one of the important strategic measures for the government to realize the equality of the basic public service. However, the public welfare goal of public hospitals is difficult to achieve by market-oriented operation alone, and needs the financial support of the state. In April 2009, the State Council announced the opinions of the CPC Central Committee and the State Council on deepening the Reform of the Medical and Health system. To a certain extent, the reform of public hospitals in our country has been promoted. Public hospitals are also gradually returning to the road of public welfare. However, there is still a lack of government responsibility in our public hospitals. The concrete performance is as follows: the orientation of government responsibility is vague; the public welfare is more and more desalinated; the government financial investment is insufficient and the use efficiency of funds is low; and there is a lack of scientific and effective compensation mechanism. If there is no unified compensation standard, the compensation mode is single, the means of paying and controlling fees are lacking, the layout of public hospitals is unreasonable, the government supervision of public hospitals is not in place, and so on. Under the background of new medical reform, the reform of public hospitals must give full play to the leading role of the government. This paper studies the reform of public hospitals in China under the background of new medical reform from the perspective of government responsibility. At the beginning, the research background of the article is described, and the research status of scholars at home and abroad is summarized by integrating the research literature at home and abroad. Then, it analyzes the government responsibility of public hospital reform on the basis of theory, and defines the related concepts of public hospital, market and the content of government responsibility. Furthermore, this paper analyzes the changes of government responsibility in the reform of public hospitals in China from two aspects: the evolution of government responsibility and the change of financial support public hospital model in the process of medical reform in China. This leads to the lack of government responsibility at the present stage in our country. Through the concrete analysis of the lack of government responsibility, this paper points out the necessity and practical urgency of the government supporting the reform of public hospitals. Next, it analyzes and summarizes the experience and enlightenment of foreign governments supporting public hospitals, as well as the experience of pilot reform of Zichang County public hospitals in China. At the end of this paper, some policy suggestions are put forward for the government to support public hospitals.
【学位授予单位】：河北经贸大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.3
本文编号：2475086
[Abstract]:Since the reform and opening up, China's economy has developed at a high speed and its per capita income has increased significantly. Along with it, the mode of economic development of our country is also realizing the leapfrogging of the new stage, which has changed from the simple pursuit of the total economic quantity and the speed of development to the pursuit of the total amount, the synchronous improvement of the quality, and the realization of the rapid and good development of the economy. With the improvement of living standards, the requirements of the people are getting higher and higher for the quantity and quality of contemporary public services, and the people-oriented value has become the main problem that the people think about. More and more attention has been paid to the quality of life and the livelihood issues closely related to themselves, especially medical and health care. The problem of "difficult to see a doctor, expensive to see a doctor" has always been a hot issue in our country. What the people are asking for is not only the increasing total amount of health resources, but also the fairness and efficiency. At present, the public medical service in our country is mainly provided through the public hospital, which is one of the important strategic measures for the government to realize the equality of the basic public service. However, the public welfare goal of public hospitals is difficult to achieve by market-oriented operation alone, and needs the financial support of the state. In April 2009, the State Council announced the opinions of the CPC Central Committee and the State Council on deepening the Reform of the Medical and Health system. To a certain extent, the reform of public hospitals in our country has been promoted. Public hospitals are also gradually returning to the road of public welfare. However, there is still a lack of government responsibility in our public hospitals. The concrete performance is as follows: the orientation of government responsibility is vague; the public welfare is more and more desalinated; the government financial investment is insufficient and the use efficiency of funds is low; and there is a lack of scientific and effective compensation mechanism. If there is no unified compensation standard, the compensation mode is single, the means of paying and controlling fees are lacking, the layout of public hospitals is unreasonable, the government supervision of public hospitals is not in place, and so on. Under the background of new medical reform, the reform of public hospitals must give full play to the leading role of the government. This paper studies the reform of public hospitals in China under the background of new medical reform from the perspective of government responsibility. At the beginning, the research background of the article is described, and the research status of scholars at home and abroad is summarized by integrating the research literature at home and abroad. Then, it analyzes the government responsibility of public hospital reform on the basis of theory, and defines the related concepts of public hospital, market and the content of government responsibility. Furthermore, this paper analyzes the changes of government responsibility in the reform of public hospitals in China from two aspects: the evolution of government responsibility and the change of financial support public hospital model in the process of medical reform in China. This leads to the lack of government responsibility at the present stage in our country. Through the concrete analysis of the lack of government responsibility, this paper points out the necessity and practical urgency of the government supporting the reform of public hospitals. Next, it analyzes and summarizes the experience and enlightenment of foreign governments supporting public hospitals, as well as the experience of pilot reform of Zichang County public hospitals in China. At the end of this paper, some policy suggestions are put forward for the government to support public hospitals.
【学位授予单位】：河北经贸大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R197.3
【引证文献】
相关硕士学位论文 前2条
1 马银华;专科公立医院运行机制改革研究[D];吉林大学;2015年
2 张金;基于社会性规制的公立医院公益性保障措施研究[D];北京中医药大学;2015年
本文编号：2475086
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