医院技术创新过程中的若干问题研究
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摘要
技术创新是技术进步的核心,包括先进科学技术知识的发现、有效扩散和应用等活动,是一个从新产品或新工艺的设想产生到市场应用的完整过程。医院作为知识型组织,具有实施技术创新的良好基础与优势。随着知识经济时代的到来、医学科技的发展和卫生体制改革的深入,医院技术创新已成为医院发展的关键性、战略性资源和新动力。
     二十世纪八十年代以来,随着我国技术体制改革的不断深化,我国医院初步形成了技术创新体系框架的雏形。同时,随着医院知识管理研究的逐步深入,人们把知识视为最重要的资源,把最大限度地发现、掌握和利用知识作为提高自身竞争力的关键。但是,目前国内学术界尚未系统地构建适合中国医院的技术创新体系,以及以医院技术创新为目标的知识管理系统,在对医院技术创新智能决策技术及医院技术创新融资机制方面还有待进一步深入研究。
     本文针对当前医院技术创新研究中存在的问题,紧紧围绕医院技术创新这条主线,依据作者在国有大型医院多年工作和专题研究的基础,通过基础理论研究和实证分析,深入研究我国医院技术创新的一般规律,为我国医院的发展提供有针对性的理论和方法支持。
     本文主要的研究工作和所取得的创新性成果包括:
     (1)将技术创新作为医院管理的核心战略问题予以研究,在总结和分析国内外学者研究成果的基础上,系统地阐述了医院技术创新与医院知识管理的基本概念和各自特征。
     (2)研究并给出了医院技术创新体系的定义,建立了医院技术创新体系的框架,对框架中的要素和结构分别进行了深入分析。
     (3)构建了以技术创新为目标的医院知识管理系统,阐明了医院知识管理系统在技术创新体系中所发挥的作用;在此基础上,以安徽医科大学第一附属医院(简称安医附院)为案例进行实证研究,构建了安医附院以医院技术创新为目标的知识管理系统。
     (4)结合医院技术创新体系,提出了一种基于灰色系统理论和人工神经网络的智能决策支持系统(IDSS)框架;运用灰色预测理论和带有自反馈的三层前向神经网络,对医院技术创新项目收益进行了动态评定,对作为医院技术创新市场要素之一的门诊量进行了预测。
     (5)对国内外医院技术创新融资机制进行了总结分析,研究并提出了基于PPP模式的医院技术创新融资机制,分析了PPP模式在我国医院技术创新中的适用性及应用PPP模式的风险,并提出了相应对策。
Technological innovation is the core of technological advancement, including discovery, effective diffuseness and application of advanced scientific and technological knowledge, is an entire process of assumption, formation and marketing application of new products and processes. As a knowledge-intensive organization, hospital has good foundations and advantages of implementing technological innovation. With the arrival of knowledge economy era, the development of the medical technology and the deepening of the reform of health system, hospital technological innovation has become a key, strategic resource and the new impetus to the hospital development.
     Since 1980s, with the reform of technology system of our country, the development pattern of technological innovation system in hospitals has been formed gradually. At the same time, with the advent of knowledge management, many experts and academicians turn to the study of knowledge management of hospital, considering the knowledge as the most important resource, and maximal discovery, use and mastering knowledge as the key to improve their own competitiveness. However, domestic scholars have not constructed Chinese hospital technological innovation systems and knowledge management system with the object of hospital technological innovation until now. Father research of IDSS and financing mechanism of hospital technological innovation is still needed.
     As to the problems existed in the hospital technological innovation, also based on years of research work and thematic studies in large state-owned hospital, this paper grasps tightly the main line of the hospital technological innovation, to explore its characteristics and laws. By means of the basic theories study and positive analyses, the paper tries to find the analysis keys of dynamic process, and some hidden laws, in order to propose methods and theories for the development of hospital.
     The main work and achievements are as following:
     (1) Technological innovation is considered as core and strategic problem of hospital management research. The basic concepts of the hospital technological innovation and the hospital knowledge management are enunciated on the basis of summary and analysis of research results of domestic and overseas scholars.
     (2) The concept of the hospital technological innovation system is defined. Based on the facts of Chinese hospital, a frame of technological innovation system is constructed, every factor and structure in the frame are also discussed in detail.
     (3) A system of the hospital knowledge management is constructed for the hospital technological innovation. Its operational process is also discussed. Furthermore, a comprehensive analysis of current conditions, advantages and disadvantages of the hospital knowledge management is presented. The effects of the hospital knowledge management on the hospital technological innovation system are illuminated. According to the study of the first affiliated hospital of Anhui medical university, a new pattern of knowledge management based on the hospital technological innovation system is discussed.
     (4) Combining to the hospital technological innovation system, the basic framework of Intelligent Decision Support System (IDSS) is designed on the basis of gray theory and artificial neural networks. Under this frame, the technological innovation profit of the first affiliated hospital of Anhui medical university is dynamically evaluated, the technology innovation ability is also decided aided with the prediction of outpatients.
     (5) A new financing mechanism for hospital technological innovation is provided based on the PPP model, in which, the applicability of PPP model working in our sanitary authority is discussed, attentions should be paid to the financing risk are analyzed. The attempt is applied to hospital financing with PPP model.
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