部分国家公立医院政府补偿机制概述及启示

Overview and enlightenment on the government compensation mechanism at some public hospital

概述了国际典型国家政府对公立医院的补偿来源及补偿方式，政府补偿建立在区域卫生规划基础上，中央财政承担了较多补偿责任，根据病例组合补偿最有激励优势，政府通过调整不同医院的拨款基准调整补偿，结合中国政府对公立医院补偿现状，分析了国际经验对我国的启示和借鉴意义，指出我国公立医院政府补偿应从按人员、按床位补偿改为按服务单元或服务量（如每次门急诊和住院床日收费）付费，过渡到按病种付费。

This paper overviewed typical government compensation sources and practices for public hospitals in the world. Government compensation should be made based on regional health planning, while the central government shoulders greater compensation responsibility. The fee-for-case mix is found to be the best incentive. The government adjusts its funding baselines for different hospitals to adjust the compensation. In view of the compensation for public hospitals in China, the paper analyzed the enlightenments and lessons from international experiences. The authors recommend an evolution from the pattern of compensation per person/per bed, to payment by service unit or volume（for example, per outpatient or emergency visit and days of stay）, and in the end to that of payment per disease.