乡镇卫生院民营化改革的实践与反思——以江苏省某县级市为例

The practice and rethought of privatizing township health center reform: Taking a county in Jiangsu province as example

乡镇卫生院的民营化转制是现实困境和社会环境因素共同作用的结果。然而,简单产权改革的手段、乡镇卫生院定位的不明确以及政府投入和管理责任的缺位导致乡镇卫生院转制后出现诸多问题。而民营化的乡镇医院的重新公有化则是在新的政策背景和现实问题促动下的乡镇卫生服务供给方式的调整,这一过程体现了不同政策背景下政府决策的变化。当然,重新公有化以后的乡镇卫生院也面临着诸多挑战,要实现改革的预期目标,需要在多方面加以改进,包括可信的政治承诺、公共财政支持、绩效考核机制的加强、多元主体的合作机制、发挥卫生服务人员的内在激励。

Transformation ownership of the township health center was influenced by the interaction factors of predicament and social background. However, many problems are emerged after the first phase of transformation process which relies on merely transfer of ownership, unclear strategic development plan and deficiency of government investment, financial compensation mechanisms and effective management. The re-socializing of township health cen- ters reflects government＇ s decision making under specific period and policy background, which also have develop- mental problems. In order to achieve the desired goals, many aspects needs to be improved, including credible politi-cal commitment, public financial support, enforcement of performance evaluation system, corporation mechanism of multiple coordination, and focus on intrinsic motivation.