江苏省公立医院法人治理模式的比较与评价研究

发布时间：2018-02-26 19:10

本文关键词： 公立医院法人治理模式比较评价江苏省　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：公立医院改革一直是卫生研究领域的重要课题之一,在我国,公立医院作为医疗服务的主体,承担着重要的责任。因此,如何把握公立医院改革的方向和力度是改革成功的关键。新医改以来,国家已多次出台相关政策、指导意见,强调推动公立医院法人治理改革,但当前公立医院法人治理改革陷入了困境,这不仅不利于公立医院的自我发展,甚至影响医疗卫生领域改革的整体效果。论文立足于江苏公立医院法人治理改革实践,首先,对江苏已有的四种公立医院法人治理模式进行定性比较并基于新公共管理理论探讨公立医院法人治理模式从公益性和效率两方面均衡评价的思路;其次,通过TOPSIS法与数据包络分析法(DEA)分别对江苏省不同法人治理模式的医院进行公益性和效率两方面评价;最后,基于公益性和效率评价结果,提出推进江苏公立医院法人治理改革的对策措施,为深化公立医院改革提供参考借鉴与实践指导。论文就上述问题开展研究,探讨江苏省公立医院法人治理模式的比较与评价研究。论文所作研究包括以下几个方面:(1)通过文献综述,系统地梳理了公立医院法人治理、公立医院公益性评价和公立医院效率评价的相关研究;(2)结合专家咨询结果,对不同法人治理模式从多角度进行定性比较分析,以期从理论上得出较优法人治理模式;(3)通过专家咨询法确立公益性评价指标体系,运用TOPSIS法和RSR法对24家江苏省地级市综合性三甲医院进行公益性评价;(4)综合运用聚类分析、相关分析与变异系数法筛选投入—产出指标,再运用数据包络分析法(DEA)对24家样本医院效率进行评价。通过理论与实证分析,论文得出江苏公立医院公益性普遍不高,且不同法人治理模式的医院公益性评价结果不同,其中董事会型模式的医院效果较差,实行行政分权与内部治理型样本医院公益性效果较好,理事会模式下的样本医院公益性评价结果最优。同时,江苏四种法人治理模式下的医院效率评价结果不同,实行理事会型模式医院效率最优,董事会型和行政分权型医院其次,内部治理型医院最低。据此,论文提出推进江苏公立医院法人治理改革的政策建议,即需要继续加大政府部门对公立医院的卫生投入;加快转变政府职能,落实政府监管职能;积极进行公立医院法人治理结构改革,优先选择理事会模式;建立与完善公立医院决策机制、监督机制与激励机制;建立完善的院务信息公开系统;创造良好外部环境,推进公立医院改革。
[Abstract]:The reform of public hospitals has always been one of the important topics in the field of health research. In our country, public hospitals, as the main body of medical services, bear important responsibilities. How to grasp the direction and strength of public hospital reform is the key to the success of the reform. Since the new medical reform, the state has issued several related policies and guidance opinions, emphasizing the promotion of public hospital corporate governance reform, However, the current reform of corporate governance in public hospitals is in a difficult position, which is not only unfavorable to the self-development of public hospitals, but also affects the overall effect of the reform in the field of medical and health care. This paper is based on the reform practice of corporate governance in Jiangsu public hospitals. This paper makes a qualitative comparison of four kinds of public hospital corporate governance models in Jiangsu Province, and discusses the thinking of public hospital corporate governance model in terms of public welfare and efficiency based on the new public management theory. Secondly, Through TOPSIS method and data envelopment analysis method, the author evaluates the public welfare and efficiency of hospitals in different corporate governance models in Jiangsu Province, and finally, based on the results of public welfare and efficiency evaluation, This paper puts forward countermeasures and measures to promote the reform of legal person governance of public hospitals in Jiangsu Province, and provides reference and practical guidance for deepening the reform of public hospitals. This paper discusses the comparison and evaluation of the governance model of public hospital legal person in Jiangsu Province. The research in this paper includes the following aspects: 1. Through literature review, this paper systematically combs the governance of legal person in public hospital. Combined with the results of expert consultation, this paper makes a qualitative comparative analysis of different corporate governance models from multiple angles. In order to get the better corporate governance model in theory, we can establish the public welfare evaluation index system by expert consultation method, and use TOPSIS method and RSR method to evaluate the public welfare of 24 prefecture-level comprehensive third-class hospitals in Jiangsu Province and make comprehensive use of cluster analysis. Correlation analysis and coefficient of variation are used to screen input-output indexes, and data envelopment analysis (DEAA) is used to evaluate the efficiency of 24 sample hospitals. Through theoretical and empirical analysis, the paper concludes that the public welfare of Jiangsu public hospitals is generally not high. The evaluation results of public welfare of hospitals with different corporate governance models are different, among which the hospital effect of board of directors model is poor, and the public welfare effect of sample hospitals with administrative decentralization and internal governance is better. At the same time, the evaluation results of hospital efficiency under the four kinds of corporate governance models in Jiangsu are different. The hospital efficiency of the board of directors model and the administrative decentralization hospital is the second. Therefore, the paper puts forward some policy suggestions to promote the reform of the corporate governance of public hospitals in Jiangsu Province, that is, to continue to increase the health investment of government departments in public hospitals, to speed up the transformation of government functions, and to implement the functions of government supervision. Actively carrying out the reform of the corporate governance structure of public hospitals, giving priority to the choice of the mode of board of directors, establishing and perfecting the decision-making mechanism, supervision mechanism and incentive mechanism of public hospitals, establishing a perfect open information system of hospital affairs, creating a good external environment, We will promote the reform of public hospitals.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.3

【参考文献】