我国公立医院管理与考核的现状、问题及政策建议

在国家增加医疗卫生投入、医疗保障覆盖面逐步扩大的情况下,加强对公立医院的考核监督,就成为保障医改效果最终实现的关键措施。目前,我国在医改中对公立医院的定位和作用认识还不够清楚、法律和政策框架不健全,尤其是对非营利性机构监管措施严重缺失;公立医院管理体制不完善,行业管理力度薄弱;公立医院治理结构不明晰,政府和公立医院之间的委托代理授权关系虚化;对公立医院考核监督体系不健全,考核结果没有充分起到激励公立医院改进绩效的作用。我们提出了强化对公立医院的监督管理的政策建议,一是明确公立医院定位,完善公立医院法制;二是理顺公立医院管理体制,提高管理能力;三是建立公立医院产权和财务管理制度;四是建立公立医院绩效考核和信息公开制度;五是加强对公立医院的立法监督和群众监督,建立公立医院审计制度和巡视制度;六是建立和完善公立医院数据收集和发布机制。

Status quo, problems and policy recommendations on the management system and performance evaluation of public hospital in China

Strengthening the management and evaluation of the public hospitals is a crucial policy in the healthcare reform.The role and function of public hospitals are not well defined due to the incompleteness of the law and regulation framework,especially the lack of legal frameworks for the regulation on the non-for-profit organization.The government does not take full responsibility as the owner and the regulator of public hospital.The evaluation system is not well set up and the evaluation result have little impact on the hospital＇ performance.We propose to strengthen the regulation and evaluation on the public hospitals.Firstly,make clear the function and role of the public hospitals and complete the public hospital legal system;Secondly,improve the management of government;Thirdly,construct the property and financial management framework;forth,construct the evaluation and information publishing institution;fifth,strengthen the regulation of public hospital from the congress and public;finally,construct and complete the statistical and data collection framework.