县级公立医院改革的实践与思考

Practice and Reflection on County-level State-owned Hospital Reform

探讨县级公立医院改革问题。通过总结分析某院医药卫生体制改革的具体做法,并对其改革前后的医院经济运行指标、患者医药费负担、财政补助等情况进行对比分析,认为改革取得了预期的成效,主要体现在:医疗收入结构发生变化,医疗服务质量的提升,药品收入所占比例下降,患者负担下降、满意度提高。同时也指出仍存在医疗服务价格调整不到位、财政补偿机制不够明确,缺乏可持续性,配套措施不够完善等一系列的问题。建议进一步加快支付制度改革,明确财政补偿办法,改善医患关系,优化医院内部管理。

To discuss the issues regarding county-level state-owned hospital reform, based on the summary of medical system reform of one hospital, contrastive analysis of financial index, patients medi-care costs, government grant before and after reform, it is proposed that reform has achieved expected efficacy, mainly in the aspects includ-ing：medi-care income structure transformation, elevation of medical service, reduction of proportion of medicine in-come, decline of patients cost and improvement of satisfaction rate. It is also pointed out that medical service price ad-justment is far from enough, financial compensation mechanism is far from accurate, sustainable and supportive mea-sures are inadequate. It is suggested that payment system reform should speed up, government compensation measures should be clarified, doctor-patients relationship should be enhanced and inner management of hospital should be op-timized.