当前公立医院法人治理结构改革进展及相关问题的认知分析——部分试点地区的典型调查  

Attitudes to the progress and related issues of corporate governance structure reform in public hospitals——qualitative research on some pilot areas

作　　者：郭蕊[1] 常文虎[1] 韩优莉[1] 

机构地区：[1]首都医科大学卫生管理与教育学院,首都卫生管理与政策研究基地,北京右安门外西头条10号100069

出　　处：《中国医院》2012年第8期22-25,共4页Chinese Hospitals

基　　金：教育部人文社会科学项目(11YJC630052);北京市自然科学基金项目(9102001);首都卫生管理与政策研究基地项目(1000170904)

摘　　要：目的:了解部分试点城市公立医院法人治理结构改革的思路、举措、预期效果和所需条件,以利于总结经验、发现问题以及研判改革的形势。方法:对深圳、北京、昆明3个公立医院改革国家联系试点城市进行现场调查,采用个人深入访谈法,访谈了9位院长和8位行政管理人员。结果:(1)对推进法人治理结构改革的必要性认识存在分歧,在具体措施和改革进程上存在较大差异;(2)公立医院法人治理结构改革中的主要问题包括:思想不统一、改革的顶层设计仍不清晰、部门利益主导改革进程、涉及多方利益调整、缺乏利益相关者参与治理的有效途径、盲目照搬国有企业法人治理改革的经验、配套改革和外部制度环境欠缺。结论:推进公立医院法人治理结构改革还要从统一思想认识出发;鼓励地方探索,注重实效,摒弃模式之争是必要途径;制度性创新是推进法人治理结构改革的关键环节;注重利益相关者的利益平衡,防止强势利益相关者侵害弱势利益群体;改善外部治理机制依然任重道远。Objectives： By leaming conception, measures, expected results and the preconditions of corporate governance stmctnre reform in some pilot pubfie hospitals to summarize experiences, find problems and evaluate the situation of corporate governance structure in publie hospital. Methods： National level pilot cities of Beijing, Shenzhen and Kunming were selected as the field investigation sites. 9 hospital directors and 8 health administrative officials were selected to have an in-depth interview. Results： （1） there is a big argulnent in understanding the importance and neeessily of the corporate governance structure reform. There are also great differences in measures and progress of corporate governance structure reform in the sited cities. （2） The non--unifotTn of reform philosophy, ambiguous top-level design, sectional inteirest leading, multi-department interest adjustment, no effectiveness way for all stakeholders parlicipalion, inflexible copying the experience of the corporate governance of state-owned enterprises reform and inappropriate external institutional environment are the main problems. Conclusions： Unify reform philosophy, encourage pilot reform, focus on effectiveness and dismiss argument on reform mode is a necessity process to carry out reform. Institutional innovation is the key point for building coiporate governance structure in public hospital. Balance interest between strong and weak stakeholders and improve external governance mechanism still has a long way to go.

关 键 词：公立医院 法人治理结构 改革进展 定性研究 

分 类 号：R197.32[医药卫生—卫生事业管理]