药品零加成背景下县级公立医院绩效改革困境

Predicament of Performance Reform of County-Level Public Hospitals Under the Background of Drug Zero-Addition

药品零加成政策全面推开以来,县级公立医院以回归公益性为目标,掀起绩效改革浪潮。县级公立医院的绩效工资制是以追求医院自身收入最大化为目标的,这与公益性的目标截然相反。政策与现实之间的困境是由政府财政补助增幅较小、医疗服务价格未能真正体现医务人员的劳动技术价值、医务人员技能和动力不足造成的。绩效改革应该明确医院创收和实现公益性目标之间的关系、统一经济效益与社会效益、平衡医务人员个人发展和医院发展,逐步实现公益性的要求。

After the implementation of the zero-addition policy for drugs,county-level public hospitals set off a wave of performance reforms with the goal of returning to public welfare.The performance pay system of county-level public hospitals aims at maximizing the hospitals'own income,which is contrary to the goal of public welfare.The dilemma between policy and reality is caused by the small increase in government financial subsidies,the failure of medical service prices to truly reflect the medical and technical value of medical personnel,and the lack of skills and motivation of medical personnel.Performance reform should clarify the relationship between hospitals'income generation and the realization of public welfare goals,unify economic and social benefits,balance the personal development of medical personnel and hospital development,and gradually realize the requirements of public welfare.