武汉市公立医院综合改革路径探析
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摘要
武汉市结合实际情况对公立医院改革进行了探索,通过高位推动改革进程、分次分批推进改革、动态调整医疗服务价格、落实政府投入责任、规划引领医疗布局、优化分级诊疗和医联体工作、斩断虚高的药品耗材价格、组建医院管理中心筹备专班,实现了医疗服务能力提升、医疗费用控制、患者就医满意度提高、公立医院能够自我补偿。结果表明,"试点先行、逐步推开",有效地保证了改革的平稳性,是一种较为有效的改革方式。
Based on the actual situation,Wuhan City explored the reform of public hospitals. Some methods were implemented,such as promoting the process of reform at a high level leadership,advancing reform in subdivision and batch, dynamic adjusting of the medical service price, implementing the responsibility of government investment,planning leading medical layout, optimizing the hierarchical diagnosis and treatment and medical union work, cutting down the price of drugs and consumables,and establishing a hospital management center preparatory class. The reform initially achieved the improvement of medical service capacity,the control of medical expenses. Patients had higher satisfaction with medical treatment,and the public hospital self-compensation capability was guaranteed. The result showed that the reform method of"pilot first and step by step"was an effective way to ensure the stability of the reform.
Based on the actual situation,Wuhan City explored the reform of public hospitals. Some methods were implemented,such as promoting the process of reform at a high level leadership,advancing reform in subdivision and batch, dynamic adjusting of the medical service price, implementing the responsibility of government investment,planning leading medical layout, optimizing the hierarchical diagnosis and treatment and medical union work, cutting down the price of drugs and consumables,and establishing a hospital management center preparatory class. The reform initially achieved the improvement of medical service capacity,the control of medical expenses. Patients had higher satisfaction with medical treatment,and the public hospital self-compensation capability was guaranteed. The result showed that the reform method of"pilot first and step by step"was an effective way to ensure the stability of the reform.
引文
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[4]乐虹,陶思羽,殷晓旭,等.面向“三医”联动的三明医改管理体制及运行机制研究[J].中华医院管理杂志,2017,33(4):247-251.
[5]谭华伟,郑万会,张云,等.公立医院补偿机制改革:典型模式和路径反思[J].卫生经济研究,2016(5):9-13.
[6]吕兰婷,王虎峰.公立医院医疗服务价格调整难点及推进策略[J].中国医院管理,2015,35(7):1-4.
[7]蒲鑫鑫,唐贵忠,何中臣.“三明路径”下深化医改的辩证思考[J].医学与哲学,2016,37(10A):63-65.
[8]方鹏骞,陈迎春,乐虹,等.三明市医药卫生体制改革评价与思考[J].中华医院管理杂志,2017,33(4):241-243.
[9]刘国恩,官海静.分级诊疗与全科诊所:中国医疗供给侧改革的关键[J].中国全科医学,2016,19(22):2619-2624.
[10]周瑞,肖月,赵琨,等.分级诊疗工作进展及问题浅析[J].中华医院管理杂志,2015,31(9):648-650.
[11]方鹏骞,闵锐,邹晓旭.我国县级公立医院改革关键问题与路径选择[J].中国医院管理,2014,34(1):4-8.
[2]伍凤兰,申勇.公立医院改革——历史演进、制度困境与路径选择[J].中国卫生政策研究,2016,9(1):34-39.
[3]曹静敏,徐爱军.我国公立医院结构布局优化的路径及思考——基于17个试点城市的经验[J].中国医院管理,2013,33(1):7-9.
[4]乐虹,陶思羽,殷晓旭,等.面向“三医”联动的三明医改管理体制及运行机制研究[J].中华医院管理杂志,2017,33(4):247-251.
[5]谭华伟,郑万会,张云,等.公立医院补偿机制改革:典型模式和路径反思[J].卫生经济研究,2016(5):9-13.
[6]吕兰婷,王虎峰.公立医院医疗服务价格调整难点及推进策略[J].中国医院管理,2015,35(7):1-4.
[7]蒲鑫鑫,唐贵忠,何中臣.“三明路径”下深化医改的辩证思考[J].医学与哲学,2016,37(10A):63-65.
[8]方鹏骞,陈迎春,乐虹,等.三明市医药卫生体制改革评价与思考[J].中华医院管理杂志,2017,33(4):241-243.
[9]刘国恩,官海静.分级诊疗与全科诊所:中国医疗供给侧改革的关键[J].中国全科医学,2016,19(22):2619-2624.
[10]周瑞,肖月,赵琨,等.分级诊疗工作进展及问题浅析[J].中华医院管理杂志,2015,31(9):648-650.
[11]方鹏骞,闵锐,邹晓旭.我国县级公立医院改革关键问题与路径选择[J].中国医院管理,2014,34(1):4-8.