基于委托代理理论的医共体治理优化探讨  

Optimization of Medical Community Governance based on Principal-agent Theory

作　　者：严玲 王晓冬[2] 黎勇[2] 李建涛 王东川 YAN Ling;WANG Xiao-dong;LI Yong;LI Jian-tao;WANG Dong-chuan(Sichuan West China Hospital Asset Management Co.LTD,Chengdu 610041,China;West China Hospital of Sichuan University,Chengdu 610041,China;School of Management,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]四川华西医院资产管理有限公司,成都市610041 [2]四川大学华西医院,成都市610041 [3]山西医科大学管理学院,太原市030001

出　　处：《现代医院管理》2023年第3期1-4,9,共5页Modern Hospital Management

基　　金：四川省科技厅软科学项目“基于四川省县级公立医院外科医师能力评价与资源配置优化的绩效管理实施基础条件研究”(2019JDR0142)。

摘　　要：目的探讨医共体治理优化路径与措施,进一步提升医共体组织决策能力,完善医共体监督,提升运行效率。方法借鉴委托代理理论,分析医共体治理模式中的委托代理问题,对标法人治理机制,分析共性及差异,提出解决方案。结果医共体与各相关组织间存在委托代理关系,同时也存在多任务代理等委托代理问题。相关委托代理问题影响医共体治理组织效率与监督效能,需要进一步借鉴法人治理机制实施优化。结论避免多任务委托是医共体治理优化的重要途径,建立责权利明晰的医共体管理法人实体并明确相关托管契约关系,可避免牵头医院法人及相关管理人员的多任务委托问题;清晰划分医共体与医疗机构的管理及责任边界,可减少决策及监督风险。Objective:To explore the optimal governance paths and measures for medical community,and further improve its organizational decision-making ability,supervision and operational efficiency.Method:By referring to the principal-agent theory,the authors analyzed the principal-agent problem in the governance model of the medical community,the governance mechanism of legal person,the commonness and differences,and puts forward the solutions.Result:There is a principal-agent relationship between the medical community and the related organizations,and there are also principal-agent problems such as multi-task agency.The relevant principal-agent problems affect the organizational efficiency and supervision efficiency of the medical community governance,so it is necessary to further learn from the corporate governance mechanism to implement the optimization.Conclusion:Therefore,avoiding multi-tasking entrustment is an important way to optimize the governance of the hospital community.Establishing a management legal entity of the hospital community with clear responsibilities and rights and clarifying the relevant trusteeship contract relationship can avoid the multi-tasking entrustment of the legal person and the related management personnel from the leading hospital.A clear delineation of management and responsibility boundaries between the medical community and healthcare institutions can reduce decision-making and supervision risks.

关 键 词：委托代理 医共体治理 法人治理 

分 类 号：R197[医药卫生—卫生事业管理]