摘要
县级公立医院改革是新医改的重点和难点,但长期以来一直滞后于医改的整体进程。通过对成都市县级公立医院改革进行问卷调查和访谈,本文发现成都市在推动医院回归公益性、降低药占比、促进优质医疗资源下沉、改善医疗环境、调动医务人员积极性、提高患者满意度、缓解医患矛盾等方面有较大改善。但是,改革过程中也存在医院法人治理形式大于实质、取消药品加成并没有完全解决药价虚高并同时伴随廉价基药难买的问题。因此,在进一步改革中,本文建议:应促进社会资本与医生技术结合,调动医生积极性,让医生回归医疗本质;应强制推动优质医疗资源梯度建设、接力、持续下沉;应优化医患关系,营造互信医患环境,重树理性的就医理念与习惯,促进医疗服务从消费品向信任品转换。
County level public hospital reform is the key and difficulty of new medical reform,but has long been lagging behind the overall process of medical reform. Through the questionnaire survey and interview on the reform of the county level public hospitals in Chengdu,this paper found that there have been big improvements in promoting the hospital to return to public welfare,reducing the proportion of medicine,sinking high-quality medical resources,improving the medical environment,arousing the enthusiasm of medical staff,improving patient satisfaction degree,easing the conflicts between doctors and patients in Chengdu. However,the form of hospital corporate governance is greater than the essence and the abolition of drug price addition did not completely solve the problem of unrealistically high drug prices,while the problem of difficulty in buying cheap basic medicine existed.Therefore,it is suggested that the combination of social capital and doctor's technology should be promoted in the further reform and the enthusiasm of doctors should be aroused to bring the doctors back to the essential work; the high-quality medical resources gradient should be promoted compulsorily,relayed,and continued to sink; the doctor-patient relationship should be optimized to build a trusting environment,rational medical ideas and habits should be re-established,so that the conversion of medical services from consumer goods to trust products can be promoted.
出处
《社会保障研究》
CSSCI
2018年第1期50-57,共8页
Social Security Studies
基金
国家社会科学基金重大项目"城乡基本公共服务均等化的实现机制与监测体系研究"(14ZDA030)成果
关键词
县级公立医院
药占比
分级诊疗
医联体
the county level public hospitals
proportion of medicine
hierarchical diagnosis and treatment
medical consortium
