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作 者:孙越[1] 吴群红[1] 梁立波[1] 黄卫东[1] 高力军[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150081
出 处:《中国医院管理》2013年第8期17-19,共3页Chinese Hospital Management
基 金:国家自然科学基金(71073044);国家自然科学基金(71203049);教育部博士点基金(20102307110018);黑龙江省卫生厅课题(2009-227)
摘 要:目的对现行医院行为规制的措施进行综合评价,确定优先干预措施。方法从重要性、可操作性、失效程度、干预迫切性等4维度建立模糊评判模型,进行综合评价与比较。结果政府缺乏有效的监管机制以及对医院和医生的投入不足是导致公立医院和医生行为扭曲的最主要的根源之所在;其次,医疗事故的举证倒置和相对滞后的支付方式是导致过度医疗服务的另一重要原因。结论实现对医院和医生行为有效控制目标的首要优先策略是建立有效的监督机制;此外,应加大对医院和医生的投入,着力完善相应的法律法规和支付机制的改革。Objectives To indentify priority interventions through comprehensive evaluation on the effectiveness of regu- lation measures on the existing hospital profit seeking behavior. Methods Evaluating and comparing the model of fuzzy comprehensive evaluation based on 4 aspects, including the importance, operability, failure degree, and intervention urgency. Results The lack of government's effective supervision on profit seeking behavior and inadequate investment to hospital and doctors were two most important reasons leading to behavioral distortion of the public hospital and doctors. The other important reasons contributing to the over-prescription of drug and excessive medical services are the onus proof burden in medical disputes and the not good functioning payment method of medical insurance schemes. Conclusion The most prioritized strategy to achieve the goal of controlling the behavior of hospital and doctors was to establish effec- tive supervision mechanism. Besides, government should increase investment to hospitals and doctors; and try to im- prove relevant laws and to reform the insurance payment.
关 键 词:公立医院 行为规制 规制失效 模糊评判 模糊矩阵
分 类 号:R197.32[医药卫生—卫生事业管理]
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