公立医院改革试点期间株洲市公立医院资源配置分析

Analysis of Resource Reallocation of Public Hospital during the Pilot Reform Period in Zhuzhou

目的:评估株洲市公立医院改革在资源配置和医院运行方面的成效,为下一步改革提供理论参考。方法:定性定量研究相结合,通过问卷调查、半结构式访谈、文献研究等方法,对株洲市公立医院改革和运行情况进行调查。结果:在资源配置方面,株洲市公立医院资源总量快速增长,但南北地区不平衡,市区和郊区发展不均衡;在绩效方面,公立医院服务数量大幅增长,服务质量没有下滑,诊疗费用涨幅略低于同期CPI涨幅,公立医院资产安全性较好,投入机制改革初显成效。结论:社会经济发展差异是卫生资源配置失衡的首要原因,应加强市级资源统筹;医院内部运行机制改革促进了公立医院运行效率;补偿机制改革仍然任重道远,应协调推进医疗保险、药品政策、价格调整等方面的改革。

Objective： To evaluate the resource reallocation and performance of public hospital during the pilot reform period in Zhuzhou city, and provide evidence for future reform. Methods： A combination of qualitative and quantitative studies was applied. Questionnaires, semi- structured interviews and reference review were taken to investigate the public hospital reform in Zhuzhou. Results： In the allocation of resources, total resources of public hospital in Zhuzhou city had a rapid growth, but it is unbalanced in different area, especially between urban area and suburbs; In the performance, the public hospital service quantity sharply increased while the quality of service stay well, cost of treatment grow slower than CPI during the same period, public hospital asset security is good, some results were shown in input mechanism reform. Conclusion： the disparity of social and economic development between urban area and suburbs is the main reason for the unbalance of health resources allocation, therefore the health resources in the whole city should be planned as a whole; the reform of hospital internal operation mechanism promoted the operation efficiency of public hospitals; Compensation mechanism reform is still a long-term task, and should be coordinated with the reforms such as medical insurance, drug policy, price adjustment.