基层公立医院治理行政再规制与市场化行为偏差之博弈

Game between Administrative Reregulation and Marketization Behavior Deviation of Primary Public Hospitals

在公立医院的市场化改革过程中,国家对医疗卫生的投入不断加大,但患者的医疗费用却依然呈增长趋势,公立医院市场化行为出现严重偏差。研究发现,成本核算是公立医院市场化行为偏差的制度起点。在新制度主义视域下,公立医院此偏差行为是在市场化改革过程中政府放松行政管制与行政再规制失衡的结果。因此,需着重加强行政再规制的力量,明确政府行政再规制的主体地位、完善相应的法律法规并提升规制的专业化水平,才能真正遏制公立医院的市场化偏差行为。

In the process of market-oriented reform in public hospitals,the government has continuously increased its investment in medical and health care,but the medical expenses of patients are still showing a growing trend,leading to serious deviations in the market-oriented behavior of public hospitals.Cost accounting is found to be the institutional starting point for marketoriented behavior deviation in public hospitals.In the perspective of new institutionalism,this deviant behavior of public hospitals is the result of the imbalance between government decentralizing administrative regulation and administrative reregulation during the market-oriented reform process.Therefore,it is necessary to focus on strengthening the power of administrative reregulation,clarifying the main position of government administrative reregulation,improving corresponding laws and regulations,and enhancing the professional level of regulation,in order to truly curb the market-oriented deviation behavior of public hospitals.