非营利性医院融资现状、关键因素与政策支撑体系研究

文章在分析我国非营利性医院各种融资方式现状的基础上,对影响融资的关键因素进行了识别,包括非营利性医院产权归属、补偿机制、规模与区域卫生规划三个方面,并从管理模式、治理结构、财政补偿、医疗保险制度、卫生资源配置和社会筹资等方面．构建了促进非营利性医院融资的政策支撑体系。     

医疗价格控制政策对医疗供求结果的影响及评价

按照新的卫生改革政策 ,国家对营利性医院提供的医疗服务将实行市场调节价 ,而对非营利性医院提供的医疗服务将实行政府指导价 ,非营利性医疗机构按照价格主管部门制定的基准价并在其浮动幅度范围内确定本单位的实际医疗服务价格。这意味着非营利性医院将以基准价、价格上限、价格下限参与医疗机构之间的竞争。一项新的价格政策的出台和逐步实施 ,对医疗供求关系将产生什么样的结果 ,必须要做到心中有数 ,以利纵驾全局 ,及时调控 ,深化和完善卫生改革。现笔者对非营利性医院的价格控制政策进行经济学的分析与评价。1　医疗价格上限对医疗服…     

非营利性医院吸收社会资本的可行性解析

非营利性医院与社会资本的有机结合是一个发展趋势，但由于民营资本参与医改暂时缺乏国家指导性政策，使得卫生行政部门、医院管理部门对非营利性医院吸收社会资本仍保持低调的态度，这在很大程度上直接影响了我国医疗卫生体制改革的进程。本项目从政策依据和医院的实际操作两个层面探讨非营利性医院吸收社会资本的可行性，为非营利性医院吸收社会资本提出相关建议。     

对营利性与非营利性医院分类管理的思考

医疗机构分为营利性与非营利性两类 ,那么两类医院各占市场多少比重 ,如何管理才能取得其最佳运行是需要探讨和研究的。一、我国医院营利性与非营利性医院的分类现状长期以来 ,非营利性医院主体是国立医院、集体医院 ,无论在城市农村都为社会提供着９５%以上的社会医疗服务量 ,由政府制定统一的收费标准 ,资金来源主要是靠政府补贴和低收费。医疗卫生事业这种福利性质与卫生计划经济体制和国家计划经济体制基本相适应。随着我国市场经济体制的建立 ,促使医疗卫生机构不断调整经营机制 ,以适应市场经济体制 ,对营利性医院与非营利性医院分类…     

社会资本举办非营利性医疗机构制约因素研究

社会资本举办非营利性医疗机构,特别是综合性医院,在我国的设立和发展仍因受到诸多因素的制约而步履维艰.通过对法律政策、卫生监管、服务价格和医疗保险因素的实例分析和理论探讨,为进一步研究社会资本举办非营利性医疗机构的政策建议提供依据.     

美国民营医院发展趋势、经验及借鉴

从床位数、服务提供等方面,描述了美国民营医院在医疗服务体系中的作用,分析其发展趋势。研究发现:民营医院是美国卫生服务的主体,2005年美国民营医院提供了82%的住院服务和72%的门诊服务,绝大多数服务由非营利性医院提供。美国经验提示:民营医院可在我国发挥更大作用,我国发展民营医院应以非营利性医院为主,且应从产权方面保证非营利医院的非营利性。     

浅议非营利性医院财务管理的目标

财务管理目标问题是财务管理的基本理论和实践问题之一。当前有人认为 ,非营利性医院财务管理目标是使医院的社会效益最大化。而笔者认为 ,社会效益在性质上并不属于非营利性医院的财务管理目标 ,而是非营利性医院搞好财务管理 ,实现理财目标的一个基本约束条件。在社会主义市场经济条件下 ,非营利性医院财务管理的目标应该是在讲求社会效益的前提下实现医院经济效益最大化。文章对研究非营利性医院财务管理目标的必要性、非营利性医院管理的目标对财务管理的要求以及非营利性医院财务管理目标与社会责任等问题进行了探讨。     

非营利性机构的经济学解释(二)

随着医疗服务市场的日臻发展与完善，医疗机构的分类管理也在不断地探索与实践。笔者在上篇(《卫生经济研究》2003．8)中分析了非营利性医疗机构产生与发展的经济理论和经济行为，在本篇中尝试对发达市场经济国家营利性医院和非营利性医院在运作中的差别进行比较分析，从而为决策者在完善医疗机构分类管理、以及规制监管民营医疗机构提供参考。     

我国医院分类管理的若干问题研究

我国政府的卫生改革政策导向已经十分明确;医院可采取营利性和非营利性两种经营方式;政府按照现代企业制度管理营利性医院;按照非企业单位的管理制度管理非营利性医院,卫生领域产权制度改革势不可挡。     

美国医疗机构分类管理的启示

为适应卫生改革形势 ,学习和借鉴美国医疗机构实行营利性和非营利性分类管理的经验和方法 ,笔者赴美考察了营利性的乔治华盛顿大学医院、非营利性的华盛顿医疗中心(WashingtonHospitalCenter)和蒙哥马利郡的一所社区医院(Shady GroveAdventistHospital) ,分别就两类医院组织结构与运作特色、资金来源与管理、税收政策等进行咨询了解 ,现将有关情况介绍如下。一、基本状况在美国 ,医院的主体是私立医院 ,约占70 %。但在私立医院中 ,并不是营利性医院占多数 ,而是非营利性医院占多数。非营利医院指社区医院、教会医院、自愿捐助者医院或其…     

美国营利性和非营利性医院的比较研究及对我国卫生改革的启示（之二）

在微观水平上分析了美国营利性医院和非营利性医院的规模,服务能力和经营状况等,在此基础之上,结合我国医疗机构分类管理的发展趋势,对我国营利性医院和非营利性医院的发展策略提出了若干建议。     

Capacity considerations and community benefit expenditures of nonprofit hospitals

The United States Internal Revenue Service (IRS) and some states require nonprofit hospitals to demonstrate that they provide a substantial community benefit in order to get or maintain their tax-exempt status. This places every nonprofit hospital at risk. This article is about certain common factors that impact the management of all nonprofit hospitals and their ability to comply with such laws.     

Consumer information and competition between nonprofit and for-profit nursing homes.

This paper develops implications of Arrow's hypothesis that nonprofit organizations are prevalent in health care because of quality uncertainty. The model analyzes the ability of nonprofits to mitigate market failures created by asymmetric information in an environment characterized by potential competition from both explicitly for-profit firms and for-profits in disguise (profit-motivated firms who obtain nonprofit status in order to exploit the perceived trustworthiness of the nonprofit sector). Under certain conditions, it is shown that nonprofit status can serve as a credible signal of quality and that nonprofits can decrease the underprovision of quality both by providing high quality services and indirectly via a spillover effect on quality in the for-profit sector. Applicability to long-term care and implications for empirical research and policy towards nonprofits in health care are discussed.     

美国非营利性医院税收法律制度研究

非营利医院在美国社会中占有重要的地位.在支持非营利医院运营方面,美国主要通过税收优惠对非营利医院进行间接支持.除税收优惠外,美国还制定了惩罚性税收和严格的税收管理制度来规范非营利医院的活动.美国非营利医院的税收法律制度为我国非营利医院税收制度提供了借鉴.我国应吸收其合理成分,以完善我国非营利医院税收法律制度.     

Strategy and marketing tactics in nonprofit hospitals.

Through the analysis of questionnaire data, this study examines the strategic management styles of 114 nonprofit hospitals and the relationship between each of these styles and hospital marketing tactics. The analysis has important implications for nonprofit hospitals and other health care organizations.     

论非营利性医院开展社区卫生服务的可行性

通过对非营利性医院行为模型的分析,提出非营利性医院实现社会福利最大化的目标;然后根据非营利性医院自身的性质,探讨了非营利性医院开办社区卫生服务中心的各种方法;最后提出了对政府、社区卫生服务中心、社区居民以及医院自身带来的好处。     

Marketing: (how) is it working?

This editorial examines possible reasons why marketing has not worked as well as originally projected in the nonprofit and public sectors. 4 possible barriers to effective marketing are proposed. 1st, marketing may not be an appropriate discipline for full implementation in the social sector. This may be why nonprofit managers adopt only fragments of the marketing model. 2nd, ideologically, nonprofit people tend not to be market-oriented. 3rd, nonprofit organizations often lack the financial resources for fully implemented, data based marketing, and 4th, social and nonprofit organizations' structures are not conducive to marketing. Marketing functions are often housed in public relations or communications departments of nonprofit organizations, and thus are not in a position to have a significant impact on the institution's operations. Of value would be a study team, composed of academicians and practitioners, to assess the situation and offer some solutions. The following 4 questions should be addressed: What is the general state of nonprofit/social marketing? Are there any organizations in which marketing is being fully implemented, with documented results? Are there any elements that are common to successful nonprofit marketing efforts? Can these common elements be exported so that other organizations can apply them?     

Measuring charitable contributions: implications for the nonprofit hospital's tax-exempt status

Since 1985, some nonprofit hospitals have tried to measure the magnitude of their charitable contributions in order to protect themselves from challenges to their nonprofit tax-exempt status. Using a sample of 562 Catholic nonprofit hospitals, this research shows that these charitable contributions may be defined and measured in several different ways, each having methodological advantages and disadvantages. The data indicate that charity care contributions vary widely, are unequally distributed across the sample of hospitals, and are influenced by the characteristics of the people in the local community and not by the characteristics of the health care delivery system. These findings suggest that legislators may be correct when questioning the rationale for the tax-exemption accorded to virtually all nonprofit hospitals. Further, it suggests that nonprofit hospital administrators can protect the tax-exempt status of their hospital by emphasizing the charitable contributions it makes by absorbing the unreimbursed costs from Medicare and Medicaid.     

An empirical comparison between the board''s strategic role in nonprofit hospitals and in for-profit industrial firms.

As the health care environment becomes more competitive, nonprofit hospitals are under pressure to adopt for-profit business practices. Based on an extensive field study, this research examines the central issue of organizational governance by comparing the strategic roles of nonprofit hospital boards with for-profit industrial boards. The results show that nonprofit hospital boards are generally more involved in the strategic decision process than their for-profit counterparts. If this governance activity is seen as desirable, hospital boards should exercise caution in emulating for-profit board practices.     

Cost of capital, target rate of return, and investment decision making.

Recent attempts to develop an investment decision criterion for nonprofit hospitals that follows that for-profit criteria have resulted in little agreement. Terminological considerations are much to blame for this lack of consensus among researchers in the field. Attempts have been made to identify a "cost of capital" for nonprofit institutions, and to employ this concept in a manner similar to the way it is employed in a for-profit setting. In fact, the application of this concept to nonprofit institutions has resulted in confusion. The use of "target rate of return" in its place would orient the debate more properly toward institutional ends and the means required to achieve them.