日本民办医疗相关服务业的发展及对我国的启示

关于日本的全民医疗保险制度,已有很多文章介绍过,大家并不陌生。但是如果提到日本的民办医疗相关服务业,了解的人就不是很多了。在此,笔者想通过介绍它的背景及其中的一个实例对其做一个概略的描述,希望对我国医疗事业发展提供一点有益的启示。1.日本民办医疗相关服务业综述在     

民营医院发展现状和规范发展的建议

民办医院是我国医疗卫生服务体系的重要组成部分.发展民营医院对于深化医疗卫生体制改革,转变政府职能,由"办医院"向"管医院"转变;对于拓宽医疗卫生事业投资渠道,促进医疗卫生资源合理配置,构建现代医疗卫生服务体系;对于形成医疗服务公平竞争机制,满足广大群众日益增长的医疗卫生需求,解决群众看病难、看病贵问题具有十分重要的意义.     

民办非营利性医疗机构发展问题及对策

新医改方案中提出鼓励和引导社会资本发展医疗卫生事业,鼓励社会资本依法兴办非营利性医疗机构。发展民办医疗机构尤其是民办非营利性医疗机构对深化医药卫生体制改革具有重要意义。然而当前民办非营利性医疗机构的发展困难重重。试图从民间组织理论的视角出发,从社会环境、内部治理和外部监督管理等方面对民办非营利性医疗机构发展面临的问题进行分析,进而提出政策建议,希望为进一步发展民办非营利性医疗机构提供思路和经验借鉴。     

福建省出台加快发展民办医院的若干意见、福建省卫生厅对医疗机构违规行为实行记分管理

本刊讯为深化福建省城镇医疗卫生体制改革 ,促进医疗卫生市场的发展 ,为社会提供多样化的医疗服务 ,更好地满足人民群众日益增长的医疗保健需求 ,根据国家有关法律、法规和《福建省人民政府关于印发城镇医药卫生体制改革实施意见的通知》的精神 ,日前 ,经省政府同意 ,省改革开放办、省卫生厅、省财政厅联合出台了《关于加快发展民办医院的若干意见》 ,以促进民办医院的发展。该意见对发展民办医院的基本原则、完善民办医院发展的外部环境、鼓励公立医院改制为民办医院和加强监督管理 ,促进民办医院健康发展等四大问题作了 2 1条具体规定。又…     

发展和规范民营医院的调查和建议

民办医院是我国医疗卫生服务体系的重要组成部分.发展民营医院对于深化医疗卫生体制改革,转变政府职能,由“办医院“向“管医院“转变;对于拓宽医疗卫生事业投资渠道,促进医疗卫生资源合理配置,构建现代医疗卫生服务体系;对于形成医疗服务公平竞争机制,满足广大群众日益增长的医疗卫生服务需求,解决群众看病难、看病贵问题具有十分重要的意义.近期,我们对民营医院发展状况进行了专题调研,现将有关情况梳理如下:……     

城市地区民办幼儿园教师流失的原因及策略分析

近年来,民办教育发展非常迅速,民办幼儿园作为民办教育中的重要组成部分,为我国教育事业的发展作出了巨大的贡献。当前民办幼儿园发展面临着很多难题。本文主要对城市地区民办幼儿园教师流失的原因进行了分析,并提出了改善的措施。     

福建省改革开放办 福建省卫生厅 福建省财政厅关于加快发展民办医院的若干意见(摘录)

发展民办医院的基本原则——民办医院是指由社会资本(含外资)为主投资兴办的符合医院基本标准的医疗机构，是城镇医疗服务体系的重要组成部分。     

农村“互联网+医疗”的发展难题与对策

"互联网+"在农村的不断扩展应用也为医疗事业发展提供了机遇。发展农村"互联网+医疗"事业,既能帮助农村构建柔性的医疗体制,推动医疗资源的流动与集聚,同时也能帮助农村医疗事业获得更多外部人才支持。但当前农村"互联网+医疗"面临顶层设计不足、发展资金短缺、人才匮乏和农民应用互联网能力弱化等多重难题。为此,规划农村"互联网+医疗"事业的整体方案、多方筹集医疗事业发展资金、积极培育农村"订单"医疗人才和推动农民深度应用医疗网络,应该成为加速农村"互联网+医疗"的重要对策。     

医疗服务价格改革的四个着力点

<正>医疗服务价格涉及医保部门、医疗机构、医务人员和患者等多方利益，有序推进医疗服务价格改革，对于深化医药卫生体制改革、推进医疗保障事业高质量发展至关重要。进一步深化医疗服务价格改革，应从完善医疗服务价格编制规范、明确项目内涵、优化医疗服务价格、完善价格管理模式四个方面持续发力，推进我国医疗保障事业高质量发展。     

上海市某区民办医疗机构执业人员现状分析与干预研究

目的为提高民办医疗卫生机构执业人员依法执业意识和知识,从而起到加强对民办医疗卫生机构业务指导。规范医疗执业行为,提高医疗服务质量。方法对某区辖区内36户民办医疗机构执业人员学历、职称、执业注册现状、依法执业等情况进行分析。开展个性化培训、问卷调查、监督检查、互动参与等卫生综合干预,并通过问卷调查、违法违规行为处理情况对比进行干预服务效果评价。结果民办医疗机构执业人员存在学历结构低、高级职称的人员缺乏的现象。培训前后问卷调查结果比较,干预前后的差异具有统计学意义。采用综合干预措施后医疗机构和医务人员违法违规行为明显减少。     

部分国家商业健康保险发展的特点及对我国的启示

本文分析了当前我国地方政府融资存在的财政自给率不足、对转移支付依赖加大、土地资源出让收入倾向最大化、地方政府债务隐性化和可持续贷款能力受限等问题,认为应正视未来20年我国地方政府在城市化进程中大规模融资行为的必然性,建议从五个方面入手来规范地方政府的融资行为,即以培育地方主体税种为基石深化分税制改革,以公共服务均等化为导向优化转移支付制度,通过正确处理土地出让金收入改变卖地财政境况,以地方政府债券发行收入来弥补市政建设缺口,以及鼓励符合条件的政府投融资平台上市融资等。     

上海发展民营医疗机构的政策建议

"上海发展社会办医"课题研究认为:上海需要根据其特点明确民营医疗机构在卫生服务体系中的定位和功能,而后将其纳入医疗机构设置总体规划,并需加强和完善以质量为核心的适合民营机构特点的监管规范,提高市场准入标准,增强其与医保联系,并对提供短缺基本医疗服务的民营机构给予政策优惠。     

中国社会办医的现状分析

通过系统分析中国社会办医的现状,为进一步促进社会办医提出政策建议。根据国内外文献,社会办医疗机构和公立医疗机构在医疗费用和服务质量方面并没有显著差异,并且由于社会办医促进市场开放与公平竞争,公立医院和整个医疗卫生服务市场的绩效也因此有所提高（正向溢出效应）。尽管如此,由于中国长期计划经济自上而下的资源配置与行政干预,社会办医长期未能得到健康发展,主要政策障碍包括准入方面存在隐形限制、经营方面缺乏税收鼓励、用人方面缺少优质医师资源。因此,建议调整区域卫生规划的功能从“封顸”向“兜底”过渡,尽快制定有利于社会办医的土地政策和人才政策,进一步完善相关配套措施,促进社会办医在中国的健康发展。     

Risks and benefits of private health care: exploring physicians' views on private health care in Ho Chi Minh City, Vietnam

As in a number of other low- and middle-income countries, the health sector in Vietnam is transforming with a rapid shift from fully state run and financed health care towards more private financing and delivery of health care. This development has been particularly noticeable in the largest city in the country, Ho Chi Minh City, where a majority of physicians now are practising in private clinics and where the private health care sector is an increasingly popular option for people. While the private sector is an important part of the health care system in Vietnam, few data are available on the characteristics and quality of private health care services. This case study describes some aspects of the re-emerging private health care sector in Ho Chi Minh City, Vietnam, from the view of 27 private and non-private physicians. The paper explores physicians' reasons for going private, physicians' notions of patients' health care preferences, and physicians' views on potential influence of financial incentives on characteristics of private health care. The characteristics of private health care are discussed in relation to a context of private health care characterised by a fully patient-financed fee-for-service payment system, weak regulatory mechanisms, and a public health care system (government-run and-financed health care) that operates under resource constraints. Issues to consider when attempting to steer private health care in Vietnam in a direction where it can optimally contribute to public health, are discussed while considering the interplay between authorised private practitioners, private pharmacies, the informal private sector, and the public health care sector.     

Household utilization and expenditure on private and public health services in Vietnam

The private provision of health services in Vietnam was legalized in 1989 as one of the country's means to mobilize resources and improve efficiency in the health system. Ten years after its legalization, the private sector has widely expanded its activities and become an important provider of health services for the Vietnamese people. However, little is known about its contribution to the overall objectives of the health system in Vietnam. This paper assesses the role of the private health care provider by examining utilization patterns and financial burden for households of private, as compared with public, services. We found that the private sector provided 60% of all outpatient contacts in Vietnam. There was no difference by education, sex or place of residence in the use of private ambulatory health care. Although there was evidence suggesting that rich people use private care more than the poor, this finding was not consistent across all income groups. The private sector served young children in particular. Also, people in households with several sick members at the same time relied more on private than public care, while those with severe illnesses tended to use less private care than public. The financial burden for households from private health care services was roughly a half of that imposed by the public providers. Expenditure on drugs accounted for a substantial percentage of household expenditure in general and health care expenditure in particular. These findings call for a prompt recognition of the private sector as a key player in Vietnam's health system. Health system policies should mobilize positive private sector contributions to health system goals where possible and reduce the negative effects of private provision development.     

民营医院纳入医保的意义与政策建议

随着国家社会办医政策的出台,民营医院发展已成为公众关心的问题,如何有效支持民营医院发展,使更多符合医疗保险定点要求的民营医院纳入医保、新农合等医疗保障体系,更好地满足百姓不同的医疗健康服务需求,成为未来政府政策关心的问题。     

私立非营利性医疗机构发展条件探讨

在私立医疗机构普遍面临发展瓶颈的情况下,我国一部分私立非营利性医疗机构却呈现良好的发展态势,这些机构在办院思路、管理体制、运行机制以及合法参与医疗市场竞争方面有许多值得借鉴的经验与做法。本文在整理归纳运行良好的私立非营利性医疗机构发展经验的基础上,认为其运行条件主要包括：医疗机构发展符合当地医疗市场需求,科学的管理体制与运行机制保证了医疗服务质量,发展定位符合区域卫生规划获得相应政策支持,以公益性为办院宗旨并且具有雄厚的资金实力,出资方通过兴办非营利性医疗机构可以获得一定的社会资本和政治资本,管理者和员工队伍素质较高。     

Lebanon's health care policy: a case study in the evolution of a health system under stress

Lebanon's experience in the development of its health care system over the last century is reviewed; inasmuch as experiences can be generalizable, the case of Lebanon reflects the attempts of middle-income countries to balance the public and private sectors' roles in health care. Lebanon's health care system followed a predictable trend that was accelerated and intensified by the civil disturbances during the past decade. Its main feature has been the absence of a coherent and sustained health policy that promotes a stable and long-lasting relationship between the public and the private sectors in health. The role of the State has been most effective during periods of political, social and economic stability, when serious planning efforts could be undertaken and resultant policies be implemented. An effective partnership between the State and the private sector is recommended for the reconstruction of Lebanon's health care system, as well as for other countries with a strong private sector involvement in health care.     

武汉市民营社区卫生的服务情况分析和对策

通过问卷调查和访谈,了解民营社区卫生服务的服务项目、服务模式和服务功能等情况,对武汉市3家民营社区卫生服务机构进行了分析,发现民营社区卫生的服务项目:重视基本医疗项目,忽视公共卫生项目;民营社区卫生的服务模式:沿用“坐堂行医”的模式;民营社区卫生的服务功能:功能缺失或空档。针对民营社区卫生服务中的不足,我们提出了相关的对策,以供民营社区卫生服务机构采取措施来完善和发展。