Impact of competition and cost containment on the university hospital

Health care delivery in the United States is proceeding through rapid evolution driven by changes in how health care providers are reimbursed. The current dominant philosophy in government is to alter the health care field from a heavily regulated one to one characterized by competition. By reducing regulatory constraints and encouraging competition, government believes more efficient health care delivery will result. Health care payment systems now include the diagnosis related group method, all-payor rates and contracting for services with major insurance companies on discount, per diem, capitation and per case rates. Reduced use of resources assumes changes in the practice of medicine from an elaborate system of medical care to a more basic one. The implications are many and the possible effects severe. There will be reduced levels of support for medical education, particularly for fellows and for those beyond the third year of residency training. A decreased hospital census and the thrust to perform more services on an outpatient basis question the basic structure of medical education focused on the inpatient. Teaching hospitals will have to develop networking arrangements, a forced cooperativeness that threatens the autonomy of training and research programs. The recent entry of for-profit health care corporations into research may compromise the integrity of the university hospital as a center for clinical care, education and research.     

党建引领医院高质量发展:以三六三医院落实党委领导下的院长负责制为例

党的十八大以来,以习近平同志为核心的党中央高度重视公立医院党的建设,提出公立医院实行党委领导下的院长负责制。从变更议事规则、构筑人才高地、强化民主决策、推进医药卫生体制改革、党建和业务深度融合等方面,探讨实施了党委领导下的院长负责制的具体做法以及取得成效,进而从加强公立医院党建工作、强化医德医风建设、完善人才引进培养任用和管理办法、落实党委履行主体责任以及纪委履行监督执纪问责等方面对党委领导下的院长负责制进行了再思考。