公立医院法人治理结构改革初探——以北京市门头沟区医院为例

目的：分析公立医院引入民营化管理对改善公立医院法人治理结构和绩效变化情况，并提出相关政策建议。方法：采用案例研究方法，通过焦点组访谈、个人深度访谈、问卷调查等，分析北京市门头沟区医院改革的做法与效果。结果：门头沟区医院2010年引入社会资本后法人治理结构得以优化，主要包括：建立医院法人治理结构，建立政府、监事会、第三方评估的多元监管体系和医院绩效考核指标体系，实施医院内部综合绩效考核制度，建立多元化投入机制等。结论与建议：改革后，医院在决策权、市场准入程度、问责机制、剩余索取权、社会功能等方面均发生改变，取得了初步效益，但也面临着一定的体制约束。公立医院治理机制改革需要创造良好的外部政策环境，进一步优化内部管理机制与考核制度，并注意在引入社会资本过程中保证提供服务的公益性。

The reform of corporate governance structure of public hospitals: A case study of Mentougou District Hospital in Beijing

Objectives： To analyze the reform of corporate governance structure of public hospitals after the introduction of the privatization management of Mentougou District Hospital in Beijing. We observed changes in the organizations performance, and made several proposals. Methods： We analyzed the background, process, and effects of the reform in Mentougou District Hospital. The data sources included in depth interview, focus group discussion and questionnaires. Results： The main approaches of the reform included establishing a corporate governance structure, establishing multiple regulatory systems and public hospital performance evaluation indicators, and establishing a supervisory board and third party assessment. A comprehensive performance appraisal system and diversified investment mechanism were also established. Conclusion： Through reform, hospital decision making power, market entry, accountability mechanisms, residual claims, and social functions have changed and achieved some positive results. However, reform has also been hampered by certain institutional constraints. The reform of public hospital governance mechanisms need a favorable external institutional and policy environment and internal management mechanism and evaluation systems need to be optimized. Particular emphasis need to be placed on introducing social capital to ensure public welfare.