实现公立医院改革突破的关键措施之我见  

Insight on breakthroughs expected for public hospitals reform

作　　者：于德志[1] 

机构地区：[1]卫生部项目资金监管服务中心,北京100009

出　　处：《中华医院管理杂志》2011年第9期641-645,共5页Chinese Journal of Hospital Administration

摘　　要：从分析当前群众反映强烈的医疗服务中最突出的过度提供医疗服务及医药费用过快增长两个问题入手，提出公立医院应实施3＋1改革模式，即推进支付方式改革、协同实施临床路径与诊处方用药规范、强化医疗监管，同时转换医院内部激励与运行机制。各项改革举措应相互衔接、相互完善，以内部激励性措施保证外部约束性改革举措的有效落实，从而实现控制费用、保证质量、转换机制、多方共赢的目标。同时，提出了实施改革应把握的关键环节及应注意的问题。In view of the two acute problems of excessive medical service and over-fast increase of medical expenditure as currently complained by the Chinese people, the author proposed that public hospitals take the 3 ＋1 pattern in their reform. This pattern calls for reform in the payment mode, cooMinated implementation of clinical pathways and standardization of outpatient prescriptions, as well as intensification of medical supervision and reform of hospital＇s internal incentives and operation mechanism. All these measures should proceed in an interconnected and mutual-improvement manner, while internal incentives should ensure effective implementation of external obligatory reform measures, in an effort to control costs, ensure quality of care, mechanism change and a win-win outcome. The paper also proposed the key points and cautions for the reform.

关 键 词：公立医院改革 突破 激励机制 医药费用 医疗质量 

分 类 号：R197.3[医药卫生—卫生事业管理]