School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, 200030, China.
School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
Front Med. 2018 Apr;12(2):218-223. doi: 10.1007/s11684-017-0534-7. Epub 2017 Jul 3.
Reforms in public hospitals are among the most important improvements in China's health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.
公立医院改革是过去 20 年来中国医疗体制改革中最重要的措施之一。然而,公立医院应进行哪些改革尚不清楚。因此,本研究提出了中国公立医院改革的可行方向,并为政府改革公立医院提供了可靠的政策建议。本研究主要使用定性研究的数据。2014 年 5 月至 12 月,在上海、广东和甘肃进行了焦点小组讨论和深入访谈。政府资金约占中国公立医院总收入的 8%,政府补贴不足严重影响了公立医院的运营机制。然而,仅仅增加这种补贴并不能解决中国公立医院激励机制不当的问题。确定中国公立医院改革方向的关键步骤是通过实施新的公立医院院长和医生评价指标体系来改变不当激励。