医院营销“源”论

市场营销理论产生于19世纪中叶，已在国际上广泛应用，而我国医院营销理论的探究刚刚起步。作者对医院营销“源”：即“三论”——三维论、蛋糕论和竞争论进行了分析。三维论：管理→经营→营销，三力合一，形成医院优势核心竞争力；蛋糕论：需要→欲望→需求→营销，做大蛋糕，扩大医疗服务市场；竞争论：入世→市场→顾客→服务→竞争→营销，医院进行资源整合，打造核心竞争力，赢得竞争，使医院在营销上领先一步，步步主动。     

医院患者服务体系的构建

医院具有自身独特的优势，在市场的竞争中充满了机会，可以预见，未来医院的竞争，不仅是医疗技术的竞争，更是医疗服务的竞争。所以从病人的实际需要出发，构建“医前-医中-医后”全程优质服务体系具有其必要性。     

新暑期医院人力资源管理创新

人力资源管理是现代管理科学中的一个重要环节，现代医院之间的竞争，归根到底是医院人力资源优劣的竞争。医疗市场的竞争迫使医院必须重视人力资源管理领域的变革，并且根据医院的发展不断地进行人力资源管理创新与开发，使得人力资源管理真正成为医院发展的“驱动器”和“润滑剂”。为加强医院的人力资源管理，提升医院管理的水平，使其管理实现向现代人力资源管理的转变，笔者认为医院必须在以下几个方面进行不断的创新和开发。     

吸引海外人才 开拓海外市场

随着医疗改革的进一步深入，医院之间的竞争日趋激烈。作为大型综合性医院，其竞争的着力点不能仅仅停留在低层次的水平上，更应在技术服务上先行一步。通过市场细分，笔者认为吸引海外人才，开拓海外市场是医院管理中又一可以采用的经营策略，这也符合经济学原理中大型综合性医院“可对细分市场中各部分分别进入，以增加市场份额”的理论。     

管理：医院运营预测

医院运营预测就是要告诉医院管理，若要在医疗服务市场的竞争中立于不败之地，就必须掌握“鉴之未来”的本领，对医院运营进行分析和研究。     

浅谈医院的文化建设

在当前医疗市场初具规模情况下，医院之间的竞争不仅仅是医院医疗技术和管理水平的竞争，更重要的是医院整体素质和整体形象的竞争，这就必须借助于医院的文化建设。医院的文化建设，是通过树立“以人为本”、“以病人为中心”的服务理念，培养医院的职工建立起一种新的道德观念、价值取向和医院精神，把职工的发展前途与医院的建设有机结合起来。这是一项系统工程，涉及到方方面面。在实践过程中，既要全面发展，又要重点突破，方能见效。     

医院也要注重品牌建设

科技进步和市场经济给医院带来机遇，也带来挑战。近年来，医院管理者已经逐渐认识到，医院应当运用现代的营销管理理念，分析市场机会，制定经营策略，打造医院品牌，创建“以人为本”的医院文化，才能在竞争中立于不败之地。     

论医疗卫生与市场经济

本文认为医疗市场客观存在，但在我国现阶段不具备医疗市场化的全部条件，医院之间技术竞争起点不一致，人才竞争不公平，价格竞争不公平，患者购买“医疗服务”的机会不等。     

小医院大专科的医院发展模式探讨

为探讨新形势下小医院持续发展模式，本阐述了该院面对激烈竞争的医疗市场，利用地理条件和政策优势。通过科学管理，走“小医院、大专科”的发展道路，使该院始终立于不败之地。     

管理：医院经营管理（上）

伴随着我国社会主义市场经济体制的确立。医疗市场环境发生了巨大的变化。以福利事业为基础的医疗格局被打破，代之而起的是“三资”医院、营利性医院和非营利性医院同台竞争。尤其人世以来，医院传统的经营管理模式面临严峻挑战。搞好医院经营管理的重要性已经凸显出来，它不仅是保证医院改革发展的基本措施，也是医院生存的现实需要。在这一深刻和全方位的变革过程中，医院中高层管理的市场意识和政策把握能力、服务理念和创新精神、竞争意识和现代化管理理念，     

医院市场竞争效果的国际经验及对我国的启示

是否在医院市场引入竞争,以及如何开展医院竞争关系我国医改走向,国际经验为解决这一问题提供了观察视角。美国医院市场竞争最为充分,以美国医院市场的研究为主,梳理医院市场竞争的效果。医院市场竞争可以在控制费用、改善质量方面发挥积极作用,但其积极作用的发挥与竞争的形态乃至医保支付方式息息相关,有必要在我国医院市场引进竞争,并考虑我国国情,合理确定医保支付方式及竞争形态。     

Hospital competition and inpatient services efficiency in Taiwan: a longitudinal study

There is no consistent evidence of the relationship between market competition and hospital efficiency. Some studies indicated that more competition led to a faster patient turnover rate, higher hospital costs, and lower hospital efficiency. Since the 1980s some studies found market competition could increase the efficiency of inpatient services. However, there were few studies testing the market competition during a hospital's earlier stages on its efficiency during later stages, or the dynamic of efficiency. In this study, we examined the effect of early-stage market competition on later-stage hospital efficiency in Taiwan, and we determine the efficiency change using longitudinal study design. The data for the analysis came from the annual national hospital survey of 1996 and 2001 provided by the Department of Health. There were 102 teaching hospital be analysed. The results show that no evidence supports the proposition that higher market competition would improve the efficiency of hospitals in delivering inpatient services in Taiwan. Importantly, neither was the inefficiency score nor the Malmquist productivity index of inpatient services associated with the level of hospital market competition, regardless of the adjustment for hospital characteristics. However, the results may be related with the hospital increasing beds investment behavior.     

医院市场竞争型态及其与医疗费用之间关系判断：以湖北省武汉市为例

目的:分析武汉市医疗市场竞争环境以及与医疗费用之间的关系。方法:采用贺氏指数计算医院的市场集中度,用统计学相关分析法判断医院竞争环境与医疗费用之间的关系。结果:2008—2010年的贺氏指数均低于1 000,贺氏指数与医疗费用之间的相关系数是0.333(P>0.05)。结论:武汉市医疗市场竞争形态为非价格竞争。     

Markets for hospital services in Zambia

Hospital reforms involving the introduction of measures to increase competition in hospital markets are being implemented in a range of low and middle-income countries. However, little is understood about the operation of hospital markets outside the USA and the UK. This paper assesses the degree of competition for hospital services in two hospital markets in Zambia (Copperbelt and Midlands), and the implications for prices, quality and efficiency. We found substantial differences among different hospital types in prices, costs and quality, suggesting that the hospital service market is a segmented market. The two markets differ significantly in their degree of competition, with the high cost inpatient services market in Copperbelt relatively more competitive than that in the Midlands market. The implications of these differences are discussed in terms of the potential for competition to improve hospital performance, the impact of market structure on equity of access, and how the government should address the problem of the mine hospitals.     

Effects of market position and competition on rural hospital closures.

OBJECTIVE: To examine the dynamic effects of competition and hospital market position on rural hospital closures. DATA SOURCE/STUDY SETTING: Analysis of all rural community hospitals operating between 1984 and 1991, with the exception of sole-provider hospitals. Data for the study are obtained from four sources: the AHA Annual Surveys of Hospitals, the HCFA Cost Reports, the Area Resource File, and a hospital address file constructed by Geographic Inc. DATA COLLECTION AND ANALYSIS: Variables are merged to construct pooled, time-series observations for study hospitals. Hospital closure is specified as a function of hospital market position, market level competition, and control variables. Discrete-time logistic regressions are used to test hypotheses. PRINCIPAL FINDINGS: Rural hospitals operating in markets with higher density had higher risk of closure. Rural hospitals that differentiated from others in the market on the basis of geographic distance, basic services, and high-tech services had lower risks of closure. Effects of market density on closure disappeared when market position was included in the model, indicating that differentiation in markets should be taken into account when evaluating the effects of competition on rural hospital closure. CONCLUSIONS: Our findings suggest that rural hospitals can reduce competitive pressures through differentiation and that accurate measures of competition in geographically defined market areas are critical for understanding competitive dynamics among rural hospitals.     

四川省医院市场结构的变化发展

利用2002—2017年四川省医院机构数据,从市场规模、市场份额和市场集中度方面分析医院市场结构的变化发展。结果:近年来医院数和床位数逐年上升,2002—2017年,医院总数从1 163所增长为2 219所,床位总数从118 593张增长为411 911张;医院数量的变化主要由一级公立医院的减少和一级民营医院增加引起。民营医院市场份额不断增加(2002—2017年床位、门诊服务、住院服务市场占比分别从3.71%、3.08%和3.12%增长为32.10%、17.78%和25.21%),但仍小于公立医院。医院市场竞争保持增大趋势,2017年约1.11%的医院市场处于完全竞争,11.11%垄断竞争,87.78%高度垄断。当前,公立医院继续主导医院市场,在新时代下,医疗供给侧改革的深化应仍然关注公立医院,同时尚有较大空间实施鼓励社会办医和促进竞争的相关政策。     

医院战略管理与危机管理融合初探

大多数医院战略管理侧重于研究医院的竞争性战略,对某些可能给医院带来灾难性后果的危机问题重视不够。而战略管理与危机管理之间存在着固有的联系,忽略一方的管理在变幻莫测的竞争市场中难以持续有效。本文尝试在医院管理过程中,将危机意识融入战略管理,形成既具有危机管理防御能力,又有战略管理市场定位能力的医院管理策略。     

差异化竞争战略在医院管理中的运用

分析了市场经济条件下综合性二级医院所面-临的挑战，结合我院托管二级医院的实践，在医院发展战略中，运用企业界推崇的波特差异化竞争战略，对二级医院生存与发展作了探讨。实践证明，综合性二级医院制定和实施差异化竞争战略，有利于保证医院组织体系的高效运转，提升医院的综合实力，保持医院的可持续发展。     

Mass retreat: the demise of Massachusetts hospital rate regulation

Massachusetts recently deregulated its 16-year-old hospital rate regulation system, after earlier voting in favor of a delay of its "play-or-pay" universal health care mandate. This retreat holds important lessons for the rest of the nation. Specific flaws in the design of the system weakened regulation's effectiveness and undermined its political support. The failure to control costs led to the postponement of universal access. Massachusetts' experience illustrates that neither competition nor regulation--as currently practiced--are adequate to meet the access and cost control challenges facing the nation.     

医院品牌建设理论与实践

随着我国市场经济的不断发展和医疗卫生事业改革的逐渐深入,医院能否适时调整经营管理策略,是关系到医院能否在市场竞争中生存与发展的关键问题。医院管理者应在加强医院质量和经济管理的同时,倍加关注医院的品牌效应,加强以患者满意度、忠诚度,医院知名度和美誉度为中心的医院品牌建设,才能不断创造优势,增强核心竞争力,使医院在市场竞争中立于不败之地。