综合性医院手术科室分配机制技术框架探讨

Discussion on the Technical Frame of Distribution Mechanism of Operation Divisions in the Comprehensive Hospital

卫生系统的改革依赖于包括分配机制在内的适宜的内部管理运行机制的催化。作者在分析综合性医院政策限度和技术限度基础上,构想手术科室分配机制的技术框架。引入“综合系数”、“人时”单位、“收入弹性系数”等概念,建立定量考核指标体系,确定指标的期望值以及各类手术之间的换算比例。分配机制紧紧依托卫生系统现有的宏观环境,机制的诱导趋势与卫生政策的导向一致。由于最重要的指标——期望月均手术量的核定是建立在现有人员构成基础上,故可以避免按床位定编将产生的人员分流组合所带来的振荡,为医院重新调配资源创造灵活的空间,同时可确保各科相互之间的比较具有水平公平性。

The reform of health system depends on the catalysis of fitting inner management operation mechanism that includes distribution mechanism. The paper put forward a technical frame of distribution mechanism of operation divisions based on analyzing policy limit and technique limit of comprehensive hospital. The paper introduced into the concepts of 'comprehensive coefficient' ,' man - hour' and 'income elasticity coefficient , and set up a series of quantitative assess indicators and confirmed expectation value of indicators and conversion proportion of all kinds of operations. Distribution mechanism depends on existing macro environment of health system, and its inducement trend is the same as that of health oplicy. Since the most important indicator, average expectation operation quantity per month, is set up on the basis of existing stuff structure, and it can avoid the vibration that bring distributary and combination of stuff according to designated bed capacity. Therefore it can create a active space ol resource reorganization for hospital and at the same time assure better level impartiality of all kinds of divisions ol hospital.