毕业后医学教育财政保障机制探索

Research on the financial guarantee mechanism for postgraduate medical education

毕业后医学教育是医疗卫生人才培养的重要阶段,主要包括住院医师和专科医师规范化培训。上海学习借鉴国际成熟经验,先行先试构建与国际接轨的毕业后医学教育制度,并将其作为政府卫生投入的重点内容,按照事权与支出责任相适应的原则,建立由政府、培训医院、社会共同承担的经费保障机制,充分发挥财政资金的政策引导作用,以结果导向为核心强化预算绩效管理,建立激励相容机制。对于住院医师规范化培训,统筹使用中央和市级财政专项补助资金,重点用于培训对象生活学习补助和培训医院教学实践活动补助;对于专科医师规范化培训,主要由市级财政出资用于培训医院教学实践补助,市、区两级财政分别出资用于所属委派医院人力成本补助。财政部门会同卫生行政部门在成本测算的基础上,制定财政补助资金支出标准,建立预拨和考核清算制度,确保财政资金使用效益。

Postgraduate medical education （ PME ） is an important stage of health personnel training, including the standardized training of resident physicians and specialists. The government in Shanghai took the lead in establishing the PME system, and put it as the priority of financing subsidy. With the government＇s authority matching corresponding duty of financing, a financial investment system from government, training hospitals and social resources has been built, and achieved the goal of motivation through the performance management and results-oriented principles. As for the training of resident physicians, the central and municipal special subsidies were used coordinately. The special subsidies were mainly used for living expenditure of trainees and practice activities expense in training hospitals. For the training of specialists, the expense of training hospitals was funded by the municipal finance, and human costs of hospitals which dispatched trainees were subsided by municipal and district levels. The standards of financial subsidy expenditure were set based on cost accounting, and the pre-appropriation and liquidation according to performance system was built to enhance the efficiency of financial subsidy.