基于健康保障责任的县级医院综合改革思路探讨

Discussion of the Multi-Reform of County-level Public Hospital Management System Based on Account of Health Security Duty

从健康保障出发,县域的医疗服务需要由县域医疗服务体系承担,其中,县域医疗服务体系主要由公立医院组成。县政府通过县域医疗服务体系管理公立医院,由此确定相应的投入责任和管理体制。在医疗服务体系的管理下,外加医疗保险及新农合对医院医疗费用的管理,县级医院依据外部环境和条件,构造内部管理体制。当前县级医院管理体制改革中存在两个关键问题:一个是农村基层医疗卫生机构(乡镇卫生院和村卫生室)在医疗服务和预防保健服务上的连体问题;另一个是在经济上调整医患双方利益问题,解决这两个问题将有利于推进县公立医院综合改革。

The county＇s health service needs a medical service set-up to take the medical service responsibility. The medical service set-up mainly consists of public hospitals. The county government governs public hospitals through the set-up to take form of the management and to be the duty of investment. In the condition of the set-up manage- ment and the medical insurance controlling-costs, the county public hospitals can build voluntarily the inside manage- ment system according to the outside management. There are two key problems in country public hospital reform, which are basic country health care organization as linkup body of two service systems and regulating the two benefit of patients and doctors in economy. The multi-reform of public hospital management system in country will go forward if the two problems to be solved.