影响医院建设PPP项目融资因素分析

以金乡县人民医院新院区项目为例,梳理医院PPP建设项目准备阶段影响融资工作的诸多要素,分析可能出现的问题,并且有效加以规范,为相关PPP项目融资运作提供参考.     

PPP项目的选择要素模型与运作模式

正在国家相关政策文件的指导下,医疗健康PPP项目的实践运作也得以快速推进。国家发展改革委PPP项目库公开发布的1043个PPP推介项目中,医院建设相关的PPP项目共有77个,总投资超过500亿元。医疗健康PPP选择要素模型虽然医院较之业务单一的PPP项目而言技术要求复杂、运营内容多样、边界弹性充分,涉及产权属性、运营设计、融资需求、改扩建需求、项目状况、     

PPP医疗项目关键成功因素分析

随着政府与社会资本合作模式(PPP)在中国的推广运用,越来越多的社会资本参与到公共设施的融资、设计、建造和运营中来。然而,由于PPP本身的复杂性和合同义务的长期性,PPP项目要实现落地并不容易。目前,部分PPP医疗项目在吸引社会资本进入和提供服务上遇到困难。本文通过文献综述和专家咨询获得中国医疗领域PPP的18个关键成功因素(CSF),包括收益分配合理、政府政策稳定、风险分担合理、职责划分明确等,并通过近期财政部PPP中心综合信息平台项目库的公开资料来验证中国PPP关键成功因素体系,为促进PPP成功达成协议提供参考。     

基于HALL模型的大型医疗PPP项目建设与运营集成管理框架研究

为缓解政府投资压力,满足多样化的医疗服务需求,引入PPP模式参与医院建设,但是在实践中医疗PPP模式仍然存在一些问题。文章在总结分析医疗建设项目和PPP项目特点的基础上,在HALL三维模型理论的基础上创新性加入空间环境维度,构建四维医疗建设PPP项目建设与运营集成管理框架模型,并对四个维度进行分析,期望能够促进我国医疗PPP的发展,为社会提供优质高效的医疗健康服务。     

我国医疗卫生领域引入PPP模式的问题与对策分析

从法律制度、运作体系、人才建设入手梳理了我国医疗卫生领域引入PPP模式存在的主要问题,并提出了建议,包括:提高对PPP模式的理性认识;加强政府引导,完善相关法律、法规及政策;加强医院PPP项目人才队伍建设。以期为促进我国医疗卫生PPP项目建设提供借鉴。     

国有医院项目融资应注意的问题

目前,预算内国有医院的发展经常受到资金不足的困扰,如果医院改制的条件尚不具备,可以引用院外资金来弥补医院资金不足。目前,国内许多国有医院在应用融资方法解决医院资金上取得了不少宝贵的经验和明显效果,为国家减轻了不少负担,使医院得到很大发展。但事物总是一分为二的,使用融资方法发展医院不可能一帆风顺,要具体问题具体分析,对此值得进行认真的研究和探讨。现就医院项目融资应注意的问题做如下讨论:1什么叫做项目融资项目融资是以项目为融资对象,对不是以机构法人为融资对象的,比如修建超级公路,勘探深海石油,购置核磁共振等项目,所…     

公益性视角的公立医院融资困境及应对策略

医疗服务需求的持续释放激发了公立医院的发展冲动,政府财政补助和医院自有资金不足背景下部分公立医院寻求市场化融资方式的支持,但是公立医院的公益性和资本的逐利性两者之间的矛盾使得公立医院融资进程陷入进退两难困境。通过对公立医院公益性内涵和PPP项目案例的分析,发现公立医院的公益性并不完全排斥资本的逐利性,资本逐利所依托的市场竞争机制也是实现公立医院公益性的前提条件。要在坚持公立医院公益性的基础上利用好市场化融资方式必须做到:第一,坚持政府在公立医院运营方向上的主导性;第二,在引进资本的同时着眼于运营机制的改革与创新;第三,将归属于政府的分红转化为对公立医院的持续性投入以支持公益性的实现;第四,结合地方政府财力采用差异化的融资模式。     

公立医院引入PPP融资模式的探讨

在我国的医疗服务提供体系中,公立医院占据主体地位,2009年公立医院数量达到14 086家,诊疗人次17.1亿人次,分别占全国医院总量的71%和诊疗人次的92.4%,为提供基本医疗卫生服务、维护国民健康做出了巨大贡献[1].然而,近些年政府投入萎缩,医院过分依赖业务收入的发展模式制约了医院的发展,也加重了整个社会的医疗费用负担.如何理顺公立医院的融资机制、拓展筹资渠道、筹集足够的资金用以弥补成本,使医院可以更好地关注社会效益,回归公益性的本途,是政府需要重点考虑的问题.近年来,国际融资领域出现了一种新的PPP模式,满足了公共部门与私营部门多方的需要,极大地推动了公用事业的发展.我们在此对该模式在我国公立医院融资中的应用加以探讨,希望对我国公立医院融资机制的改革有所启示.     

医疗设备融资租赁项目流程及风险防范探讨

目的：医疗设备融资租赁具有操作灵活简便、资金一次性投入少等特点,能快速更新医院设备,提升医院竞争力。方法：通过文献分析和调查,介绍医疗设备融资租赁的含义,并与银行融资、政府贷款融资作比较,以及在融资项目中医院应采取的风险防范措施。结果：重点介绍直接租赁和售后回租,两种典型租赁模式的项目执行流程;并提出融资租赁项目决策分析的4种理论即净现值理论、类比估算理论、成本现值比较理论和专家判断理论。结论：医疗机构若利用融资租赁来购入先进的医疗设备,需要对融资租赁的项目流程有基本的了解,科学决策,审慎签订租赁合同。     

英国医院政企合作开发模式研究及启示

政企合作（Public-Private Partnership,PPP）是英国医院建设的主要模式,通过对英国医院PPP模式主要内容和发展历程的分析和总结,得出对我国医院PPP的启示。     

公立医院公私合作面临的投融资政策困境及其出路

本文回顾了公立医院PPP适用的投融资政策和主要实践模式,分析了公立医院PPP面临的如何合理确定PPP设备设施项目,评估公立医院投资资产价值,让合作双方获得合理回报等投融资政策困境,在此基础上提出了公立医院摆脱困境的出路,包括加强合作项目前期可行性论证,贯彻区域卫生规划和医疗机构设置规划要求;加强公立医院PPP项目有形资产和无形资产的评估,防止国有资产流失;加强公立医院PPP财务信息披露,维护公立医院公益性和职工合法权益。     

An analysis of ophthalmology services in Finland - has the time come for a Public-Private Partnership?

Background  

We studied the prerequisites for Public-Private Partnership (PPP) in the context of the Finnish health care system and more specifically in the field of ophthalmology. PPP can be defined as a more or less permanent cooperation between public and private actors, through which the joint products or services are developed and in which the risks, costs and profits are shared.     

基于PEST-SWOT整合模型的公立医院PPP适用性分析

随着政府与社会资本合作(Public Private Partnership,PPP)模式在我国医疗卫生领域大量应用,提高供给改善服务的同时也出现了很多困难和挑战。为了解决这些问题,通过PEST-SWOT整合模型,对公立医院应用PPP模式适用性进行分析,从政府和公立医院视角,进行外部环境条件机会与挑战分析和内部因素优势劣势识别,并提出相应的PPP模式应用策略,从而确保PPP项目物有所值,实现项目目标,为公立医院应用PPP模式提供理论依据和参考。     

Life of a partnership: the process of collaboration between the National Tuberculosis Program and the hospitals in Yogyakarta, Indonesia

Public-private partnerships (PPP) for improving the health of populations are currently attracting attention in many countries with limited resources. The Public-Private Mix for Tuberculosis Control is an example of an internationally supported PPP that aims to engage all providers, including hospitals, to implement standardized diagnosis and treatment. This paper explores mainly the local actors' views and experiences of the process of PPP in delivering TB care in hospitals in Yogyakarta Province, Indonesia. The study used a qualitative research design. By maximum variation sampling, 33 informants were purposefully selected. The informants were involved in the Public-Private Mix for Tuberculosis Control in Yogyakarta Province. Data were collected during 2008-2009 by in-depth interview and analyzed using content analysis techniques. Triangulation, reference group checking and peer debriefing were conducted to improve the trustworthiness of the data. This analysis showed that the process of partnership was dynamic. In the early phase of partnership, the National Tuberculosis Program and hospital actors perceived barriers to interaction such as low enthusiasm, lack of confidence, mistrust and inequality of relationships. The existence of an intermediary actor was important for approaching the National Tuberculosis Program and hospitals. After intensive interactions, compromises and acceptance were reached among the actors and even enabled the growth of mutual respect and feelings of programme ownership. However, the partnership faced declining interactions when faced with scarce resources and weak governance. The strategies, power and interactions between actors are important aspects of the process of collaboration. We conclude that good partnership governance is needed for the partnership to be effective and sustainable.     

公立医院公私合作模式的案例分析——以上海市浦东新区为例

通过借鉴国内外医疗领域PPP模式经验,以浦东新区ZP医院二期项目为案例,创新性探索设计了BTOT(Build-Transfer-Operate-Transfer)的运作结构,通过成立项目公司举办社会资本为主的民办非营利性医疗机构,并采用资产租赁费与运营管理费的形式作为回报路径。在此基础上,从机构性质与国民待遇、产权归属与风险规避、利益平衡与合作期限、核心医务人员的配置等方面提出了相关对策思考,以期在公立医院改革与发展领域探索可复制的PPP模式。     

A Study on the Public-Private Partnership to Global Health Issues in Korea

ObjectivesTo find the fit that is most apt for the current situation in Korea and to find new ways of identifying potential partners for the purpose of public–private partnership (PPP). The research was conducted using domestic and international literature where the concept and definition of PPP was stated, and cases of PPP reported by the World Health Organization and cases in developed countries were investigated.Materials and methodsData were collected from 237 PPP potential partner organization, government agencies, and the government under a special law, local governments, businesses, hospitals, and private organizations through their internet webpage. The Delphi questionnaire was given to relevant institutions and questionnaire was surveyed general hospitals.ResultsGroups that were likely to realize most of the partnership were nonprofit or nongovernmental organizations, the central government, the private sector, public healthcare services, and products.ConclusionIn order to secure the position of exceptional comparative advantage of international expertise in the field of healthcare, we must implement PPP strategy that is in ordinance of domestic situation.     

公私合作制度对我国发展社会办医的启示

新医改形势下,政府大力鼓励社会办医,其中公私合作制度(PPP)是解决公立医院融资困难,加快公立医院改革与建设的重要路径和尝试.结合PPP在国内外的成功经验,立足我国公立医院发展实际,探讨更好地让社会办医落地的政策建议:一是加强PPP模式的制度建设:将社会办医纳入医保,鼓励医师多点执业;二是完善社会办医补偿机制;三是将社会办医纳入医联体共建.