试论社会主义市场经济条件下医院的内外环境与发展

试用巴纳德的社会系统平衡理论并结合权变理论,分析在社会主义市场经济条件下医院的内外环境与发展,寻求保持医院内外环境平衡的对策。区域卫生规划、医疗保险制度改革和医药卫生体制改革使医院面临严峻挑战,在改革的大环境下,医院内部运行还不能很快适应改革的需要。思想观念不能及时转变,服务意识淡薄,医疗供求矛盾尖锐,以病人为中心的医疗服务模式还没有建立起来;医院尚缺乏科学管理,人事制度改革有待深入,分配制度改革还相对滞后。作者认为,医院的发展规模要与区域卫生规划相匹配,发展适度规模,加强内涵建设。医院的经济运行要与市场经济相协调,增加财政补助,制定合理的价格政策,提高医疗技术劳务价格,降低医疗服务成本。医疗服务供给要与病人需求相平衡,尽快建立以病人为中心的医疗服务模式。医院的管理要与卫生体制改革相适应,引进竞争机制,走创新之路。

A Discussion on the Internal and external Circumstances and the Development of the Hospital under Socialist Market Economy

According to Barnard's society system balance theory and adaptability theory, the internal and external circumstances and the development of hospital under socialist market economy are analyzed to seek a countermeasure for keeping a balance between the internal and external circumstances of the hospital. The regional health care programming, the reform of medical insurance system and of the medicine health care system makes the hospital face critical challenge. Comparing with social reform, the mechanism of hospital internal performance can not match the needs of the reform in a short period of time. Idea changing is slow, Service consciousness is dim and the contradiction between medical supply and demand is getting sharper. The mode of taking the patients as the center of medical service is not established. The scientific hospital management is weak, the reform of personnel system needs to deepen and the reform of contribution system lags behind relatively. The authors suggest that the size of the hospital should be in accordance with the regional health care programming and hospital should strengthen the internal construction. Hospital economic performance should assort with market by raising the finance subsidy and constituting reasonable price policy to increase value of medical services and reduce the cost of them. The supply and demand of medical service should be balanced and the medical service mode taking the patients as the center should be established as soon as possible. The hospital management should adapt to the health care system reform, with introducing the competitive mechanism and wending an innovative way.