合则增益 分则偏颇——试论公平与效率的关系及在医院管理中的作用

Benefit If Combined and One-sidedness if Separated——A Discussion on the Relationship between Equity and Efficiency and Its Function in Hospital Management

正确处理公平与效率的关系,发挥两者的作用是医院管理的实质性内涵和全部工作。医院改革也好,改制也好,改进也好,都离不开公平与效率的关系。在处理公平与效率关系方面,可谓是诸子百家,仁者见仁,智者见智。笔者认为,公平与效率应该是优化组合的关系,公平是前提,效率是基础;公平是目的,效率是手段,是一个有机的整体,互为支撑,相辅相成。就医院而言,“追求社会公平,注重服务效率,兼顾经济效益”就较好地体现了辨证法中“两点论”和“重点论”的观点,也较好地体现了医疗卫生行业的公益性和与时俱进的时代性。在医疗服务过程中,政府和市场在处理公平与效率关系问题上,各有千秋,政府主导公平,市场引导效率,医院作为载体,尽力靠近公平,努力提高效率,应该也是可能做到的。最后,笔者认为,政府、市场、医院三者的完美融合是实现公平与效率优化组合的保证,这是本文的主旨。

To handle with the relationship between equity and efficiency correctively and put them into full display are the essential contents of hospital management,No matter what kinds of changes you have： hospital reform, system change, or improvement for hospitals, the relationship between equity and efficiency must be taken into account.When it refers to how to handle those two issues, different people have different opinions.The writer believes that the relationship between equity and efficiency should be combined optimally; equity is the precondition while efficiency is the foundation： equity is the destination, efficiency is instrument and it forms an organic system. That, supports and complement to each other .For hospitals, “To pursue social equity, pay attention to service efficiency, and mean while take economic efficiency into account”, have embodied the dialectical view “theory of two points and theory of emphasis”, and emibodied the public benefit of medical and health care industry, In the course of medical service, when dealing with the relationship between equity and efficiency, the government and market both have its advantages.The government mainly pays attention to equity： the market takes care of efficiency： hospital, as the carrier, tries its best to promote equity and meanwhile make it more efficient.Sure perfect outcome can be achieved. Finally, the writer thinks that the perfect combination of government, market and hospital is the important guarantee to realize the integration of equity and efficiency,which is also the paper＇s gist.