营利医院所有制与老年医疗保险费用增长的关系研究

美国近来由非营利所有制转变为营利所有制的医院越来越多。研究人员比较了营利医院和非营利医院服务地区的老年医院保险人均费用。在研究年份中,医院均保持营利所有制的２０８个地区,老年医疗保险的人均总费用高于医院都保持非营利所有制的２８６０个地区,混合地区的费用居中。在考察的每一类医疗服务中,营利医院地区的费用均高于非营利医院地区。从１９８９年到１９９５年,人均费用增长最快的是医院服务和家庭保健。在所有医院     

医疗服务的品质考核

在可以自由选择的情况下，为什么要办非营利医院？为了回答这个问题，不少人容易到税收方面去打主意。是的，各国政府通常给非营利医院以免税的优惠。营利医院抽税，非营利医院免税，形成了一个相对价格之差。逻辑上，只要这个差价足够大，总有人趋利避害，出头来办非营利医院吧？     

营利医院所有制与老年医疗保险费用增长的关系研究

美国近来由非营利所有制转变为营利所有制的医院越来越多。研究人员比较了营利医院和非营利医院服务地区的老年医疗保险人均费用。在研究年份中 ,医院均保持营利所有制的 2 0 8个地区 ,老年医疗保险的人均总费用高于医院都保持非营利所有制的 2 86 0个地区 ,混合地区的费用居中。在考察的每一类医疗服务中 ,营利医院地区的费用均高于非营利医院地区。从 1989年到 1995年 ,人均费用增长最快的是医院服务和家庭保健。在所有医院均由非营利变为营利所有制的 33个地区 ,人均费用增长比所有医院仍保持非营利所有制的 2 86 0个地区更快。因此 ,研究人员认为营利医院服务区的老年医疗保险人均费用和费用增长均高于非营利医院服务区。ElaineM .等人在 1999年 8月 5日出版的TheNewEnglandJournalofMedicine上发表研究结果。     

当前医院营销中的问题与对策

随着医疗卫生体制改革的不断深入和中国加入WTO，广大人民群众的医疗需求发生了变化，医疗服务市场的竞争也日趋激烈。医院要在竞争中求得生存和发展，不仅仅取决于医疗水平的优劣及服务质量的高低，还要取决于医院营销水平的高低。但当前在医院     

医际竞争与管理调控

医际竞争是指提供医疗卫生服务的主体之间的竞争,是一种优胜劣汰行为。医际竞争不同于经济领域里的竞争,更不同于体育场上的竞争,它没有纯粹的观众,所有的人们,尤其是患者都将承受医际竞争带来的后果。所以,人们对医际竞争非常敏感,特别关注。目前,国家已经确定医院分为两种类型,一种为营利型,一种为非营利型,但不论哪种类型,都离不开市场经济的社会大环境,都逃避不了医际竞争的现实,即使是非营利型医院,也必须具有竞争意识,把握竞争机遇,服务社会,发展自     

「两大阵营」——我们比什么?

加入世贸组织,意味着医疗机构运行全球一体化,面对国外资金、管理、技术、服务的冲击,我国医疗机构面对国内国际两个市场。在日前举办的一次"中国医院院长高峰论坛"上,来自营利和非营利医院"两大阵营"的院长们热烈探讨两个层面的竞争焦点     

医院物价管理与医院经济健康有序发展

医疗费用是就诊患者除健康之外关心的另一个重要问题,医疗费用的高低间接影响患者的身心健康。因此,降低医疗费用,制定和执行合理的药品、医疗服务价格显得尤为重要。医院作为医疗价格的执行单位,虽然没有价格定制权,但拥有价格使用权。     

医院所有制与效率：以德国为关注重点的研究回顾

德国医院市场在过去20年里进行了一揽子医疗改革,特别是在2004年引进了疾病诊断相关分组——以期提高医院效率。本文旨在回顾近期就比较德国公立医院、私立非营利医院和私立营利医院效率所开展的研究。尽管研究结果错综复杂,但结合其他国家,特别是美国的研究证据,德国方面的研究结果表明:与公立医院相比,私立医院(私立非营利和私立营利医院)的运营效率并不一定就高。由于私立营利医院通常都会被认为是最有效率的所有制形式,因此本研究结果对很多决策者来说也许有些意外。     

营利与非营利医疗机构的判定和监测

任何医疗机构有向居民提供基本医疗和执行国家定价的权利，机构营利与非营利的性质主要应由机构自己决定并由其经营行为体现。医疗服务营利具有自发性和隐蔽性，政府必须进行严格的判定和监测，以保证消费不受欺诈和医疗市场的公正和公平。监测利用服务价格、财务收支、基本医疗服务比重、人均工资、奖金、福利等各项指标。进行医疗机构的分类管理应该做好几项基础工作，包括核算服务项目的标准成本，进行合理定价，进一步界定基本医疗，确定非营利机构的合理奖金福利水平，建立医疗管理信息系统，建立专业审核监测组织，确立管理机制和决策程序等。     

医院定位的思考

医院定位就是确定医院在医疗服务市场中的位置和总体形象，包括医院的地理位置、性质、类型、功能、规模、服务能力、服务价格、发展战略等。现实的诸多例证表明，医院定位是否科学、准确，不但关系到医院功能的发挥，而且关系到医院的存在与发展。我们认为，在我国医疗服务市场不断开放、医院竞争日趋激烈的形势下，认真思考、准确把握、及时调整医院定位，对于维系医院的生存、促进医院的发展、提高全民健康水平都是非常必要的。     

非营利性医疗机构补偿机制研究

2000年，我国将医院分为营利性和非营利性两类，大多数公立医院属于非营利性的医院，它在提供基本医疗服务、公共卫生服务和提高健康状况方面发挥着重要作用。政府对非营利性医疗机构补偿不足，已严重影响了医院的发展。文章分析了我国非营利性医疗机构在补偿方面存在的问题，对建立非营利性医疗机构的合理补偿机制的方式及对策进行了探讨。     

Hospital competition and financial performance: the effects of ambulatory surgery centers

Ambulatory surgery centers (ASCs), limited-service alternatives for treating surgery patients not requiring an overnight stay, are a health-care service innovation that has proliferated in the U.S. and other countries in recent years. This paper examines the effects of ASC competition on revenues, costs, and profit margins of hospitals that also provided these services as a subset of their general services in Arizona, California, and Texas during the period 1997-2004. We identified all ASCs operating during the period in the 49 Dartmouth Hospital Referral Regions in the three states. The results of fixed effects models suggested that ASCs are meaningful competitors to general hospitals. We found downward pressure on revenues, costs, and profits in general hospitals associated with ASC presence.     

Competition or Coordination in Hospital Markets with Unionised Labour

This paper study labour market responses to hospital mergers. The market consists of two hospitals providing horizontally and vertically differentiated services. Hospitals compete either in price and quality or just in quality (non-price competition). To provide medical care, hospitals employ health care workers (e.g., physicians, nurses). The workers collectively bargain wages either at a central level, firm level or plant level. Anticipating wage responses, hospitals decide whether or not to merge. The main finding is that the bargaining structure, the nature of competition and the patient copayment rate have a crucial impact on the profitability of hospital mergers.     

上海市三级公立医院特需服务发展的现状及趋势分析

目的:分析上海市三级公立医院特需服务发展的现状和趋势,为完善相关政策提供依据。方法:梳理公立医院特需服务管理的相关政策,并对2011—2013年上海市三级公立医院提供特需服务的机构数量、服务数量、价格、费用等进行定量分析。结果:上海市相关政策对特需服务规模具有明确要求,住院床位费、住院诊查费、护理费、门诊诊查费可由医院自主定价。2013年,上海市89.7%的三级公立医院开展了特需服务,特需服务数量变化较为平稳,但医院之间收费差别较大,2013年上海市三级公立医院特需服务总费用占全院总费用的6.2%,药占比低于全院平均水平。结论与建议:公立医院特需服务的存在具有历史必要性,短期内应加强其监管。公立医院应加强自身管理,规范提供特需服务。借鉴国际先进经验,形成公立医院多层次的医疗服务格局,并积极开展与社会办医疗机构的合作。     

Nonprofit to for-profit conversions by hospitals, health insurers, and health plans

Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services.     

Does competition improve hospital performance: a DEA based evaluation from the Netherlands

Many countries have introduced competition among hospitals aiming to improve their performance. We evaluate the introduction of competition among hospitals in the Netherlands over the years 2008–2015. The analysis is based on a unique longitudinal data set covering all Dutch hospitals and health insurers, as well as demographic and geographic data. We measure hospital performance using Data Envelopment Analysis and distinguish three components of competition: the fraction of freely negotiated services, market power of hospitals, and insurer bargaining power. We present new methods to define variables for each of these components which are more accurate than previously developed measures. In a multivariate regression analysis, the variables explain more than half of the variance in hospital efficiency. The results indicate that competition between hospitals and the relative fraction of freely negotiable health services are positively related to hospital efficiency. At the same time, the policy measure to steadily increase the fraction of health services contracted in competition may well have resulted in a decrease in hospital efficiency. The models show no significant association between insurer bargaining power and hospital efficiency. Altogether, the results offer little evidence that the introduction of competition for hospital care in the Netherlands has been effective.

     

三级医院在线医疗社区使用情况研究——以北京市为例

目的:分析三级医院在线医疗社区使用情况,为三级医院互联网医疗的发展和医疗资源优化配置提供依据。方法:选取北京市三级医院为研究对象,使用Python语言设计网络爬虫程序爬取好大夫在线医疗社区中北京市医疗机构和医生的网页信息,使用频数、百分比、均值等统计指标,运用t检验、方差分析等方法,构建多重线性回归模型,分析三级医院在线医疗社区的使用情况。结果:公立三甲医院和高级职称医生是在线医疗社区医疗服务的主要提供者。与在线医疗社区医生累计帮助患者数相关的因素包括医院类别、医生所在科室、医生职称、推荐热度、感谢信数和礼物数。结论:在线医疗社区拓展了三级医院提供医疗服务的途径,提高了三级医院优质医疗资源的可及性和利用率,对于促进医疗服务的连续性具有一定的积极意义。应鼓励三级医院积极利用现有商业在线医疗社区或自行搭建在线医疗社区平台。     

社区护理管理发展现状研究进展

社区医院是我国医疗单位中最为基层的诊疗机构,也是数量最为众多的医疗单位。其肩负着基础医疗服务、慢性病管理、预防接种、术后及慢性病康复、相关重大疾病转诊等诸多医疗相关服务。近年来随着我国医疗体制的改革,社区医院护理的工作重点及使命也发生了重要转折。社区医院作为基层医疗单位应肩负起更多的医疗服务,坚持小病进社区,大病进医学中心的原则。随着社区医院医疗使命的转变,其相关的护理管理工作也发生了相应的变化,对医院护理管理人员也提出了新的要求。本文结合近年来社区医院职能相关变化,进行了文献复习并做一简要综述,以期为社区医疗管理工作提供一定的参考依据。     

Regulating risks: consumer protections in provider health networks

As competition for health care dollars grows fierce, physicians and hospitals are going head to head with insurance companies. They are forming new partnerships, broadly called provider-sponsored organizations, that cut out the middleman and have the potential to furnish better care at lower prices. But legislators, regulators, and consumers must understand the dangers inherent in the structure of some PSOs.     

Patient satisfaction with health services in Bangladesh

Concern over the quality of health care services in Bangladesh has led to loss of faith in public and private hospitals, low utilization of public health facilities, and increasing outflow of Bangladeshi patients to hospitals in neighbouring countries. Under the circumstances, assessment of the country's quality of health care service has become imperative, in which the patient's voice must begin to play a greater role. This study attempts to identify the determinants of patient satisfaction with public, private and foreign hospitals. A survey was conducted involving inpatients in public and private hospitals in Dhaka City and patients who have experienced hospital services in a foreign country. Their views were obtained through exit polls using probability and non-probability (for foreign hospital patients) sampling procedures. Regression models were derived to identify key factors influencing patient satisfaction in the different types of hospitals. Doctors' service orientation, a composite of 13 measures, is the most important factor explaining patient satisfaction. Policy implications are discussed.