我国公立医院医师多点执业的利弊分析

Analysis of Positive and Negative Aspects on Physician Dual Practice of Public Hospitals in China

对医师多点执业的各种争议和影响进行梳理和归纳,分析我国公立医院医师多点执业对医生、患者、公立医院和医疗市场的影响。参照国际上多数国家多点执业政策,探讨在我国实行利润限制、身份限制、时间和场地限制、服务量限制及负向激励等策略的可行性。我国医师多点执业可采用身份限制和服务量限制的组合限制性政策,以适度减少多点执业对公立医院的冲击,以及对医疗服务总量、医疗服务质量、医疗服务质量和效率、医疗公平性的负面影响。

This article concluded and analyzed several controversies and influences of physician dual practice as well as its positive and negative effects on public on private dual practitioners,patients,public hospitals and health care market. It also discussed the feasibility of implementing dual practice policy allowed with restrictions in China,such as restrictions on private sector earnings,licensure,allocated time and working place,service provision and using reverse incentives referring to international experiences on dual practice policy allowed with restrictions. Finally,this article suggested combining restrictions on licensure and service provision in order to mitigate its negative impact on public hospitals and influence on aspects including access to services,quality of services,efficiency and cost of services and equity of services.