综合监管背景下构建医疗服务信息披露的制度框架和政策建议

Research on the Institutional Framework and Policy Suggestions of Medical Service Information Disclosure under the Background of Comprehensive Regulation

建立多元化综合监管体系,是推进医疗卫生行业治理体系和治理能力现代化的重要标志。医疗服务信息披露作为强化问责和监管的重要工具之一,国内外陆续开展医疗服务信息披露的实践。本文从信息披露制度有效性出发,以嵌入理论为逻辑分析框架,分析医疗服务信息披露成为医疗服务监管有效工具的关键在于披露信息嵌入医院管理者和患者行为的作用机制。信息披露只有嵌入医患决策行为中,通过患方赋权和供给侧竞争并达成医患互动,才能实现制度引导下放权强管、放管结合的监管目标。在目前的制度环境下,须根据医疗服务信息披露对供需双方行为的影响路径,从认知、需方、供给侧和文化等方面进行多维嵌入的制度设计。

Establishing a diversified comprehensive regulation system is an important symbol for promoting the modernization of the governance system and capacity of the health industry.As one of the most important policy tools to strengthen accountability and supervision,medical service information disclosure has been carried out in many counties.Because of the particularity of public hospitals and health information market asymmetric characteristics,whether the implementation of the medical information disclosure institution can change the behavior of the patients and hospital administrators?This paper uses the double-sided embeddedness theory as the logical analysis framework,to analyze the information disclosure institution as an effective tool for comprehensive regulation depending on the mechanism of information disclosure embedded in hospital administrators and patients’behavior.Through the empowerment of the patient and the competition on the supply side and the interaction between doctors and patients,the regulatory goal can be achieved.Under the current institutional environment,a multidimensional embedded institutional design should be carried out from the perspectives of cognition,demand-side,supply-side and culture.