浙江省县级公立医院综合改革的进展、挑战与对策

公立医院改革是当前医改的重点难点问题，浙江省以药品零差率为切入点，以“五环联动”为政策保障，启动了全省县级公立医院综合改革，形成群众、政府、医院和医务人员多赢的局面。在此基础上，继续深入推进公立医院综合改革，针对控制医疗费用不合理增长、体现群众得实惠、规范医疗服务等挑战，提出进一步完善改革配套政策、探索改革新举措、加强医疗服务行为监管等对策与建议。

A comprehensive county-level public hospital reform in Zhejiang province: Progress, challenges and countermeasures

Public hospital reform has been an issue of priority and difficulty in the current heahhcare reform. A comprehensive county-level public hospital reform in Zhejiang province, taking as its breakthough point the initia- tive of zero price-difference of pharmaceutical products, and supported by an ＂interacting 5-policy＂ approach, has led to a muhi-win situation that benefits the population, government, hospitals as well as medical staff. Zhejiang province has built on this and continued to explore new approaches to a comprehensive urban public hospital reform, and further the reform in depth by improving supporting policies, introducing innovative measures and strengthening supervision over medical service activities. Against control medical spending unreasonable growth, reflecting the people get benefits, standardized medical service, put forward countermeasures and suggestions further improve the reform and supporting policies, explore new reform initiatives and strengthen the supervision of medical services.