我国公立医院医疗服务支付制度改革与发展的思考

医疗服务支付制度改革是深化医改的组成部分,我国将大力推行支付制度改革试点,逐步完善医疗服务的支付制度.本文在对当今的公立医院补偿机制以及与其密切相连的、按项目付费支付制度的负面作用产生的历史根源、理论根源进行分析研究的基础上,对公立医院的性质、公立医院的补偿机制的理论基础进行了论述.探讨了新形势下推行支付方式改革的原则和要点,提出了当前应以医疗服务支付制度改革为契机,将其与解决公立医院补偿机制顽疾紧密相连,把实现"控制费用、强化管理、确保质量、转换机制、实现多赢"作为支付制度改革的核心目标,将公立医院改革引向深入.

Reform and development studies of medical payment system in China's public hospitals

Reform of the medical service payment system plays a key role in deepening the ongoing health reform.China will launch in a large scale the trials of the payment system for its betterment.The author probed deeply into the current compensation mechanism of public hospitals,as well as the inherent and theoretical roots of the negative outcomes resulting from the item-based payment system.On such basis,the paper discussed the nature of the public hospitals,and the theoretical basis for public hospitals' compensation system.In addition,the author discussed the reform principles and key points for reforming the payment system amid the ongoing health reform,proposing to link this reform with resolving major setbacks of the compensation mechanism of public hospitals.Objectives for the medical service payment system reform are advocated as follows: Cost control,management enhancement,mechanism shift,and win-win,which aim to deep reforms of the public hospitals.