公立医院规制失效现况评价研究框架与主要结果  

Research Framework and Main Result of the Current Situation Evaluation on Hospital Regulation Failure

作　　者：吴群红[1] 孙越[1] 丁玎[1] 

机构地区：[1]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150086

出　　处：《中国医院管理》2013年第7期8-9,共2页Chinese Hospital Management

基　　金：国家自然科学基金(71073044);教育部博士点基金(20102307110018);黑龙江省卫生厅课题(2009-227)

摘　　要：目的系统梳理我国公立医院规制内容及工具体系,评价和筛选规制失效关键节点及其影响因子,为进一步改善我国公立医院规制效果提供决策依据。方法通过文献研究及专家讨论构建研究框架、研究内容与目标,运用因子分析、逻辑回归、模糊评判、TOPSIS等综合评价方法分析影响因子及失效关键点干预清单。结果运用多种综合评价方法发现了制约我国医院规制目标实现的关键失效节点和瓶颈因素,深入分析了影响规制效果充分发挥的规制体系因子及规制执行障碍因子,并从医院准入、费用、质量控制、医保、价格、行为规制等多个领域筛选了优先干预清单。结论导致我国公立医院规制总体效果不佳的根源之一是医院规制体系设计本身及其执行工具和条件不足,其次是受各种障碍因子的制约而导致的医院规制执行力不强而产生的结果。Objective To systematically study the contents and instruments of hospital regulation system in China, to identify the key failures and their influencing factors, to provide evidence for better hospital regulation in China. Methods Through literature research and thematic group discussion, building research framework, content and objectives, by applying method of factor analysis, logistic regression, fuzzy comprehensive evaluation, TOPSIS and other methods, finding out the key points of hospital regulation failure and influencing factors. Results Difficulties of public hospital regulations and their influencing factors are analyzed, problems existed in the hospital regulation system design and major obstructive factors that hindering its smooth implementation are identified, and prioritized intervention list is se- lected from various regulation areas： such as cost , quality, pricing, behavior regulation etc. Conclusion The key under- lying causes for overall poor performance of hospital regulation in China are poor hospital regulation system design, un- satisfactory implementation due to powerful obstructive factors.

关 键 词：医院 规制失效 关键节点 瓶颈因素 

分 类 号：R197.32[医药卫生—卫生事业管理]