公立医院补偿机制改革国际比较研究

The international comparison of compensation mechanism in public hospital reform and references to China

目的:通过对国外公立医院补偿机制改革做法的比较研究,为中国下一步补偿机制改革提供借鉴。方法:主要通过PubMed、SCI等专业数据库与相关网站查询专业文献,从改革政府财政投入、改革支付方式和理顺医疗服务价格体系三方面对世界各国公立医院补偿机制改革加以分析;数据主要来源于WHO 2013年度卫生报告和2012年中国卫生统计年鉴。结果:通过对国外公立医院补偿机制改革的研究,提出了推进我国公立医院补偿机制改革的启示,即提高医保支付水平、采取混合支付方式、增设药事服务费、拓宽补偿渠道等。结论:公立医院补偿机制研究是一个政府、医院、病人、社会等多重因素相关的复杂问题,政府财政投入是世界各主要国家公立医院的主要补偿方式,预付制为主的混合支付方式是国际上补偿机制改革的主要趋势,而理顺医疗服务价格体系是补偿机制改革的重要内容,由此才能够引导医疗卫生事业走向更加健康的轨道。

Objectives：Through the practice of comparative research of foreign public hospital compensation mechanism reform to provide references for the reform of China＆#39;s compensation mechanism. Methods：In this article, the author mainly retrieves professional literature by the specialized database （PubMed, SCI） and the related website. Through three aspects named the reform of government financial input, payment reform and straightening out the medical service price system, public hospital compensation mechanism reform of various countries were analyzed. The data mainly came from the World Health Statistics 2013 by WHO and China Health Statistics Yearbook 2012. Results：By studying abroad public hospital compensation mechanism reform, we have put forward references for China＆#39;s public hospital compensation mechanism reform, such as broadening the channels of compensation, advocating mixed mode of payment, raising the level of medical insurance payment, allocating health expenditure proportion of government, society and individual reasonably, adding service charges of pharmaceutical affairs. Conclusions：Research of public hospital compensation mechanism is a complex problem which is related to multiple factors such as government, hospitals, patients and society. The government financial investment is a main public hospital compensation mode in many countries. The system of mixed payment in advance is the main trend of international on compensation mechanism reform, and straightening out the medical service price system is the important content of the reform of the compensation mechanism. Because of these factors, we can guide the development of national healthcare to a better road.