公立医院范畴的国际比较与界定

International Comparison and Definition of Public Hospital Category

公立医院改革是医疗卫生体制改革的重要内容。然而,我国各界对于公立医院的范畴存在多种认识。当前存在三种主流的公立医院范畴观,即国有公立医院范畴观、事业单位公立医院范畴观和卫生行政机关隶属的公立医院范畴观。在大部分发达国家和地区,政府将公立医院的范围限定为卫生行政机关直接运营和管理的医院。综合考虑我国公立医院职能、政府财政能力、医疗卫生行政管理体制和政府绩效管理等因素后,仅将直接隶属于卫生行政机关的医院纳入公立医院范畴是较为科学的。此种界定将面临现实的挑战,需要政府通过完善公立医院法律体系,设立公立医院管理局、规范各类国有医院职能等方式化解改革的阻力。最终推动公立医院改革有序进行。

The reform of public hospitals is an important content of medical and health system reform. However, there are a variety of awareness about the public hospital category from all walks of life in our country. There are three mainstream views about public hospital category. The first view is that public hospital is the state- owned hospitals. The second view is that public hospital must be institution membership. The third view is that public hospital is the ones which are run by the administrative organ of health. In most developed countries and regions, the government adopted the third views. According to the function of public hospital in our country, government finance ability, medical administration system, government performance management and other factors, the scientific choice is that public hospital is the ones which are run by the administrative organ of health. In fact, this definition will face challenge. It needs the government to improve the legal system of public hospitals, the establishment of Public Hospital Management Bureau, regulate various functions and resolve state-owned hospital reform resistance. Ultimately, Definition of the category of public hospital will promote the reform of public hospitals.