英国医疗服务PPP模式的研究

发布时间：2018-03-08 16:14

本文选题：公私合作伙伴关系(PPP)　切入点：私人融资计划(PFI)　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：提供优质、便利的医疗服务是每个国家都关注的问题。但是,随着人们对医疗服务需求的增加以及人口老龄化的加剧,仅依靠政府的人力、物力、财力来满足显得日渐力不从心。世界卫生组织鼓励各国在卫生工作上引入市场的力量,越来越多的国家在提供医疗服务方面与社会资本合作。英国在二战后建立了国民医疗服务体系(National Health Service,NHS),这种广覆盖、高福利性质的医疗体系很快令国家财政不堪重负,医疗服务的质量也急剧下降。二十世纪90年代,英国将PPP(Public-Private Partnership,公私合作伙伴模式)引入医疗服务领域。由私营部门对医院进行设计、改造、维护,并提供非核心医疗服务,政府向私营部门支付费用购买服务。这种利用私营部门资金、管理优势的模式使得英国的医疗设备短时间内得到改善、工程按时完工率以及计划成本内完工率都得到大大提升。政府由提供医疗服务转为购买医疗服务,由办医院变为管医院,从而有更多的精力去制定规章制度、完善医疗体系。英国在医疗PPP模式上的实践无论是数量还是成熟度方面都是世界领先地位,很多国家对此进行学习、借鉴。我国在新医改之后就鼓励社会资本以多种方式参与提供医疗服务,2013年开始,PPP模式在我国迎来了新时期,项目数量庞大、逐渐走向规范化是这一时期的特点。在这样的背景下,将两者结合可以改善我国在医疗服务领域的些许问题。但是,相比较其他领域,医疗领域民营资本参与的积极性不高。这其中的一大原因就是我国以往在公私合作领域的实践集中在水电等经济类基础设施,在医疗服务方面缺乏示范经验。所以,在这种背景下,研究英国在医疗领域的PPP模式对我国开展医疗PPP实践有一定借鉴作用。本文的研究方法主要有文献分析法和案例分析法。对PPP模式的内涵、特征以及意义等基础理论分析时运用文献总结、分析。通过对英国的一个典型医疗案例进行介绍、研究,以期从中看出得与失,成功之处与不足之处,为我国未来医疗PPP事业提供经验借鉴。本文的研究结构如下:第一章阐述了本文的研究背景、意义、思路、方法,以及对国内外的部分文献做了概述。第二章介绍了PPP模式的定义、理论基础与典型结构,接着研究了PPP模式在医疗服务领域的运作模式、实践情况以及成效。第三章研究了英国医疗服务PPP模式的发展历程以及特征。第四章对英国西米德尔塞克斯大学医院PFI项目从操作模式、指标评估、法律依据、监管、优劣等方面进行了案例研究,期望从中得出英国医疗PFI项目的一些共性问题。第五章分析了英国医疗服务PPP项目隐患与挑战的具体表现。第六章介绍了我国现阶段医疗PPP项目的现状。指出了英国医疗PFI模式对中国不完全适用的原因:中英医疗服务体系不同以及中英应用PPP模式的目的不同。而在对公立医院的公私合作的法律政策上可以单独设计这一点我国可借鉴的英国经验,另外将PPP项目的监督职能落实到具体部门也是我国现阶段需要学习加强的。
[Abstract]:To provide quality and convenient medical services is concerned about the problems of each country. However, with the increasing demand of medical services and increasing aging population, only rely on the government's manpower, material resources, financial resources to meet become increasingly powerless. WHO encourage countries introduced in health work on the strength of the market, more and more countries in providing medical services cooperation and social capital. The British established the national health service after World War II (National Health Service, NHS), the wide coverage, high welfare medical system quickly made national fiscal burden, quality of medical services decreased rapidly. In twentieth Century 90s, the British PPP (public-private partnership mode Public-Private Partnership) into the field of medical services. By the private sector of the hospital for the design, renovation, maintenance, and provide non core medical services Wu, the government to the private sector to pay the cost of purchase of services. The use of private sector funds, management advantages of the model makes the medical equipment short time within the UK is improved, the project completed on time and cost rate plan completion rate have been improved greatly. The government by providing medical services to purchase medical services by hospitals into tube the hospital, which have more energy to formulate rules and regulations, improve the medical practice in the medical system. PPP model of the UK both quantity and maturity are the leading position in the world, many countries are learning, reference. In our country after the new medical reform to encourage social capital to participate in a variety of ways to provide medical services, 2013 to usher in a new era of PPP mode in our country, a large number of projects, gradually standardized is the characteristics of this period. In this context, the combination of the two can be In order to improve some problems in the field of medical service in our country. However, compared with other areas, the enthusiasm of private capital to participate in the medical field is not high. One of the reason for this is our past practice in the public-private cooperation field concentrates in hydropower and other economic infrastructure, lack of demonstration experience in medical service. So, in this context, the research in the medical field PPP model has some reference for our country to carry out the practice of medical PPP. The main research methods are literature analysis and case analysis. The connotation of PPP mode, using the literature summary, analysis of characteristics and significance of the basic theory. Through a the typical case of British medical research are introduced, in order to see gains and losses, successes and shortcomings, to provide experience for China's future PPP medical career. This study is structured as follows: The first chapter describes the research background, the significance, ideas, methods, and the domestic and foreign literature are summarized. The second chapter introduces the definition of PPP model, and the typical structure of the theoretical foundation, then study the operation mode of PPP mode in the field of medical service, practice and results. The third chapter studies the development of the course of British medical service PPP mode and its characteristic. The fourth chapter of the British Schmid M Sykes University Hospital PFI project from the mode of operation, evaluation, supervision, legal basis, made a case study on the pros and cons, expect to draw some common problems of the project from the British Medical PFI. The fifth chapter analyzes the specific performance problems and challenges of medical English the PPP service project. The sixth chapter introduces the present status of health PPP project in China. It is pointed out that the cause of British Medical PFI mode is not fully applicable to the China: British Medical The application and service system of different PPP mode for different purposes. And can design this point in our country can be used for reference in the legal policy of public-private partnership in public hospitals on the British experience, will also need to learn to strengthen the implementation of supervision function of PPP project to specific departments is also our country at the present stage.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R199

【参考文献】