我国公立医院治理改革的挑战与解决思路

公立医院治理是关于政府作为所有者和监管者与公立医院管理者之间的职责、权利和义务的制度化安排。我国公立医院治理改革面临的主要挑战是:对改革方向的认识不统一和操作路径不清晰;改革的动力不足;存在公共治理与公司治理的认识误区;公共治理的社会参与发展薄弱;管办分开和政事分开的操作思路尚未厘清;公立医院治理改革的外部环境不配套。推进改革需要明确公立医院组织变革的最终目标;下一步应大力推进相关配套改革;推进公立医院公益事业法人治理改革试点;启动事业单位组织变革的立法程序。

The challenges and strategies for reform in public hospital governance in China

The public hospital governance is an institutional arrangement of the responsibility, rights and obligations between governments, as the owners and the supervisors, and the managers of the public hospitals. The main challenges in the reform in public hospital governance are those that there are no consensus on the direction of the reform and there are no clear paths were identified; there is lack of momentum for the reform; there is misunderstanding of public governance and corporate governance; there is a weak social participation in public governance; there is no clear way for separating the ownership and operation, the public policy making and business administration; there is lack of suitable external environment for the reform. For pushing the reform, it is necessary to set up goals for the organizational reform; make great effort to push the related reforms which are the matching supports to the main reform; conduct some pilots of the reform; and start the process for legislation for the organizational reform in public institutions.