發(fā)布時間：2019-05-12 03:51

【摘要】：改革開放以來，我國經(jīng)濟高速發(fā)展，，人均收入水平顯著提高。伴隨而來的是我國的經(jīng)濟發(fā)展方式也在實現(xiàn)著新階段的跨越，已經(jīng)從單純的追求經(jīng)濟總量和發(fā)展速度轉(zhuǎn)向追求總量、質(zhì)量的同步提升，實現(xiàn)經(jīng)濟又快又好發(fā)展。 隨著生活水平的提高，對于當代公共服務的數(shù)量和質(zhì)量，人民群眾的要求也越來越高,人本價值也成為了人民思考的主要問題。越來越多的關注焦點放到了生活質(zhì)量和與自身密切相關的民生問題，這其中尤為突出的是醫(yī)療衛(wèi)生。 “看病難、看病貴”問題一直是我國的熱點問題。人民群眾要求的不僅僅是不斷增加的衛(wèi)生資源總量,我們更關心的是公平與效率。我國目前的公共醫(yī)療服務主要是通過公立醫(yī)院提供的，公立醫(yī)院是政府實現(xiàn)基本公共服務均等化的重要戰(zhàn)略舉措之一。然而，公立醫(yī)院公益性的目標，單靠市場化的運作難以實現(xiàn)，需要國家給予財政方面的支持。 2009年4月,國務院公布了《中共中央國務院關于深化醫(yī)藥衛(wèi)生體制改革的意見》。一定程度上推進了我國的公立醫(yī)院改革的步伐。公立醫(yī)院也逐步回歸到公益性的道路上。 然而，我國公立醫(yī)院仍然存在著政府責任缺失問題。具體表現(xiàn)為：政府責任定位模糊；公益性越來越淡化；政府財政投入不足且經(jīng)費使用效率低；缺乏科學有效的補償機制。如沒有統(tǒng)一的補償標準、補償方式單一、支付控費手段欠缺；公立醫(yī)院布局不合理；政府對公立醫(yī)院監(jiān)管不到位等。新醫(yī)改背景下，公立醫(yī)院改革必須充分發(fā)揮政府的主導作用。 本文以政府責任視角研究新醫(yī)改背景下我國公立醫(yī)院的改革。開篇先對文章的研究背景做了闡述，并通過整合國內(nèi)外的研究文獻，歸納總結(jié)了國內(nèi)外學者的研究現(xiàn)狀。接下來，對公立醫(yī)院改革的政府職責進行理論基礎上的分析，并對公立醫(yī)院相關概念、市場與政府職責的內(nèi)容進行界定。 再者，從我國醫(yī)改過程中政府責任演化歷程和財政支持公立醫(yī)院模式的變化兩個方面，縱向分析中國公立醫(yī)院改革中政府責任的變化。由此引出我國現(xiàn)階段存在的政府責任缺失問題。再通過對政府責任缺失問題的具體分析，指出政府支持公立醫(yī)院改革的必要性和現(xiàn)實緊迫性。接下來，分析總結(jié)國外政府支持公立醫(yī)院的經(jīng)驗和啟示、以及我國子長縣公立醫(yī)院試點改革經(jīng)驗。本文的最后，提出我國政府支持公立醫(yī)院的相關政策建議。
[Abstract]:Since the reform and opening up, China's economy has developed at a high speed and its per capita income has increased significantly. Along with it, the mode of economic development of our country is also realizing the leapfrogging of the new stage, which has changed from the simple pursuit of the total economic quantity and the speed of development to the pursuit of the total amount, the synchronous improvement of the quality, and the realization of the rapid and good development of the economy. With the improvement of living standards, the requirements of the people are getting higher and higher for the quantity and quality of contemporary public services, and the people-oriented value has become the main problem that the people think about. More and more attention has been paid to the quality of life and the livelihood issues closely related to themselves, especially medical and health care. The problem of "difficult to see a doctor, expensive to see a doctor" has always been a hot issue in our country. What the people are asking for is not only the increasing total amount of health resources, but also the fairness and efficiency. At present, the public medical service in our country is mainly provided through the public hospital, which is one of the important strategic measures for the government to realize the equality of the basic public service. However, the public welfare goal of public hospitals is difficult to achieve by market-oriented operation alone, and needs the financial support of the state. In April 2009, the State Council announced the opinions of the CPC Central Committee and the State Council on deepening the Reform of the Medical and Health system. To a certain extent, the reform of public hospitals in our country has been promoted. Public hospitals are also gradually returning to the road of public welfare. However, there is still a lack of government responsibility in our public hospitals. The concrete performance is as follows: the orientation of government responsibility is vague; the public welfare is more and more desalinated; the government financial investment is insufficient and the use efficiency of funds is low; and there is a lack of scientific and effective compensation mechanism. If there is no unified compensation standard, the compensation mode is single, the means of paying and controlling fees are lacking, the layout of public hospitals is unreasonable, the government supervision of public hospitals is not in place, and so on. Under the background of new medical reform, the reform of public hospitals must give full play to the leading role of the government. This paper studies the reform of public hospitals in China under the background of new medical reform from the perspective of government responsibility. At the beginning, the research background of the article is described, and the research status of scholars at home and abroad is summarized by integrating the research literature at home and abroad. Then, it analyzes the government responsibility of public hospital reform on the basis of theory, and defines the related concepts of public hospital, market and the content of government responsibility. Furthermore, this paper analyzes the changes of government responsibility in the reform of public hospitals in China from two aspects: the evolution of government responsibility and the change of financial support public hospital model in the process of medical reform in China. This leads to the lack of government responsibility at the present stage in our country. Through the concrete analysis of the lack of government responsibility, this paper points out the necessity and practical urgency of the government supporting the reform of public hospitals. Next, it analyzes and summarizes the experience and enlightenment of foreign governments supporting public hospitals, as well as the experience of pilot reform of Zichang County public hospitals in China. At the end of this paper, some policy suggestions are put forward for the government to support public hospitals.
【學位授予單位】：河北經(jīng)貿(mào)大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.3

【引證文獻】

相關碩士學位論文 前2條

1 馬銀華;�？乒⑨t(yī)院運行機制改革研究[D];吉林大學;2015年

2 張金;基于社會性規(guī)制的公立醫(yī)院公益性保障措施研究[D];北京中醫(yī)藥大學;2015年

本文編號：2475086