江苏省公立医院体制改革的探索与思考

The exploration and thinking on system reform in public hospitals in Jiangsu Province

分析了现行公立医院体制的主要弊端,即体制单一,缺乏活力;权责不清,缺乏动力;运行成本高,缺乏竞争力。从组建医院集团,促进医疗资源优化;实行托管制,促进经营权与所有权的适度分离;发展个体私营医疗机构,调整医疗资源的所有制结构;发展社区卫生服务,促进城市医疗服务体系的结构调整等方面介绍了江苏省公立医院体制改革的初步探索。在此基础上提出了公立医院体制改革的思路:规划医疗机构设置,明确政府办医职能;优化医疗资源配置,提高公立存量资源利用率;改制形式因地制宜,改制过程积极稳妥;改革经营体制,实行两权分离;推进配套改革,促进健康发展。

The article analyzes the malpractices of public hospitals, namely, single system, lackof vitality; power and duty are not clear, lack of motivation; high operation cost, lack of competition.It introduces the initial exploration in public hospitals in Jiangsu Province in the following areas:establishing hospital group to promote resource optimization; conducting trusteeship to promote proper separation of operating power from ownership; developing private medical institutions to adjustthe structure of medical resources; developing community health care service to promote the structuraladjustment of urban medical care service system etc.. And based on it, the article outlines the ideas forsystem reform in public hospitals: to plan the placement of medical institutions to make clear the dutyof government in running medical institutions; to optimize the installation of medical resources toenhance the utilization rate of public resources in stock; the form to change the system should be basedon the local situation and the its process be proper; to reform operating system to separate the twopowers; to promote matching reform to improve sound development.