广东省公立医院发展现状与对策

目的通过对广东省公立医院2000—2005年的发展现状研究,了解广东省公立医院发展中存在的问题和困惑,并提出相应的建议,为有关部门制定医疗卫生政策提供依据。方法通过整群抽样选取广东省21个地级市254家公立医院采用统一设计的调查表进行函调,并对珠三角和非珠三角2类地区5个地市17家医院进行现场考察和焦点访谈。结果(1)广东省各地各级公立医院规模都有明显扩张,但区域发展不平衡;(2)人员和床位编制滞后于实际需要;(3)政府对公立医院的职能定位不清,补偿机制不健全;(4)医疗纠纷及医疗事故争议日渐增多;(5)医疗欠费现象普遍;(6)医患关系紧张;(7)医护人员产生职业倦怠。结论与建议(1)明晰公立医院的定位,既要严格控制医院规模,又要给予适当的发展空间;(2)明确公共财政对公立医院的补助政策;(3)重视医疗纠纷对医院带来的负面影响,联合各部门建立和谐医疗环境;(4)强化监督管理,改善医患关系,提高人民健康水平。

Current Developing Situation and Countermeasures of Public Hospitals in Guangdong Province

Objective Through the survey on the current developing situation of public hospitals of Guangdong Province between 2000 and 2005,profile of development and puzzles existing in them would be found and suggestions for decision making would be put forward afterward.Methods 254 public hospitals in 21 municipalities in Guangdong Province were selected into the sample pool,and a designed questionnaire were sent to the hospital by mail and called back.17 hospi- tals in 5 municipalities including the Pearl-river-delta Area and Non-pearl-river-delta Area were chosen as research field and focused interview were adopted as the main method to collect qualitative materials.Results(1)The scale of public hos- pital at all levels in all parts of Guangdong Province was obviously expanded,but development was unevenly;(2)The planning of personnel and beds lag the actual need;(3)The government had neither clear functional orientation for public hospitals,nor sound compensation mechanism;(4)Medical dispute and malpractice dispute increase day by day;(5) Arrears for medical treatment became common phenomenon in public hospitals;(6)The relationship between medical personnel and patients was tense;(7)The medical personnel got occupational accidie.Conclusion and suggestion( 1 ) Clarify the orientation for public hospitals and control the scale of the hospital strictly with proper development space; (2)Define the subsidy policy of public finance to public hospitals;(3)Pay more attention to the negative effect on the hospitals that bring by medical disputes,and unite every related department to set up harmonious medical environment; (4)Strengthen supervision and improve the relationship between medical personnel and patients,to improve health levels of people.