公立医院筹资补偿机制的探讨

Establishment of a public-good oriented mechanism for the financing ＆ compensation mechanism of public hospitals

“为群众提供安全、有效、方便、价廉的医疗卫生服务”是《公立医院改革试点指导意见》提出的公立医院医疗卫生服务的总体目标，这一目标的实现仅靠改革公立医院内部运行机制是很难奏效的。公立医院的投入机制、区域医疗卫生服务体系的布局、医院所在地的经济与产业状况、医疗保障（险）的支付额度与支付审批程序等众多因素直接影响医院的投入与产出。本文从我国医院的投入补偿机制人手，分析了医院投入与产出的特征，提出建立基于公益性绩效的公立医院投入补偿的观点，为进一步完善公立医院的管理体制、形成以公益性为导向的公立医院运行机制提供参考依据。

Access of safe, effective, convenient and affordable medical and health care services to the people is set as the goal of public hospitals health services as stated in the ＂Guidelines for Public Hospitals Pilot Reform＂. Such a goal, however, can hardly be achieved by mechanism changes within the public hospitals. The input and output of public hospitals rely critically on such factors as the input mechanism, regional pattern of healtbcare system, the economic and industrial conditions of the region, payment quota and payment approval procedures of medical insurance. This paper set off from the input compensation mechanism of public hospitals in China and analyzed the input and output characteristics of the hospitals. Furthermore, the paper proposed to establish an input compensation mechanism based on public welfare performance for such hospitals. This provided further reference for improving the management of public hospitals and building a public welfare-oriented operation mechanism of public hospitals.