公立医院产权改革、服务半径和合作效率——基于南昌三三四医院改制的案例研究  

Property Rights Reform,Asset specificity and Medical Service Efficiency:A Case Study Based on the Transformation of Nanchang Sansansi Hospital

作　　者：张平 张子悦 甘筱青 ZHANG Ping et al(Study Centre for the Yangtze River urban agglomeration ,Jiujiang, P. R. Chin)

机构地区：[1]长江中游城市群与昌九一体发展研究中心,江西九江332005 [2]南昌三三四医院

出　　处：《中国卫生事业管理》2016年第10期724-725,765,共3页Chinese Health Service Management

基　　金：国家自然科学基金资助项目:"全民医保条件下双向转诊的机制设计及医疗机构间协调研究"(编号:71263029)

摘　　要：当前对公立医院能否改制成独立经济利益的法人治理结构和能否通过医院之间的市场竞争来达到医疗资源的有效配置充满争论。文章从医疗资源的资产专用性视角,对南昌三三四医院改制前后的经营过程进行分析,对比改制前后医院的绩效,研究影响医院效益的主要因素。通过研究发现,公立医院改制并不必然提升医院的经营效益。竞争背景下医院服务效率提升的同时是医疗服务成本的不合理上升、医疗机构间合作的虚化和医疗体系的整体绩效的下降。而实施医护人员的社会化培养和市场化执业,通过市场竞争促进医护人员的合理流动能够使得医疗资源达到优化配置。本文对探索公立医院改革的主要方向提供新的视角,在当前公立医院改革的关键时期具有重要的理论和现实意义。Currently,reform of public hospitals achieved in consensus,but whether the property right reform of public hospitals can improve the medical service efficiency and allocate the medical resources efficiently,which is full of controversy.Based on the theory of the asset specificity,this paper made the case study in the activities of Nanchang sansansi hospital.Compared with hospital performance before and after the hospital property right reform,and study the impact and related consequences. The study found that it is not necessary to improve the hospital performance through the property right reform.Under the circumstance of market competition,the improvement of hospital efficiency can always increase cost of medical services unreasonably,undermine cooperation works among different medical institutions and decrease the overall performance of medical system. While implement the healthcare industry training system,not hospital training system for health workers and allow the doctor to practice freely.The competitive flow of healthcare works can allocate the medical resources efficiently.This paper provides the new perspective on the main direction of the public hospital reform and is of great significance to both theory and practice when the public hospital reform enters a critical period.

关 键 词：产权改革 资产专用性 医疗服务成本 合作绩效 

分 类 号：R197.3[医药卫生—卫生事业管理]