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中国私立医院的快速发展:对卫生部门管理的新挑战与机遇

Rapid growth of private hospitals in China: emerging challenges and opportunities to health sector management.

作者信息

Zhang Xiaoxi, Zimmerman Armand, Zhang Yanyan, Ogbuoji Osondu, Tang Shenglan

机构信息

School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Center for Policy Impact in Global Health, Duke Global Health Institute, Duke University, Durham, North Carolina, United States.

出版信息

Lancet Reg Health West Pac. 2023 Dec 19;44:100991. doi: 10.1016/j.lanwpc.2023.100991. eCollection 2024 Mar.

Abstract

China's private hospital market has experienced rapid growth over the last decade, with private hospitals now outnumbering public hospitals by a factor of two. This policy analysis uses available data and existing literature to analyze China's rapidly changing hospital market, identify key challenges resulting from rapid private hospital growth, and present recommendations to ensure future sustainable private hospital development in the country. Our analysis shows that while private hospitals outnumber public hospitals, outpatient visits and hospitalizations remain higher among public hospitals, while per-patient expenditure remains higher among private hospitals. Key challenges to private hospital development include limited government financial support, high tax burdens, difficulty in workforce recruitment and retainment, poor government regulation and oversight, and dissipating public trust. Recommendations to address these challenges include opening government contract bidding to private hospitals, creating a system that allows private hospitals to enter national health insurance schemes, reducing tax pressure on private hospitals, defining a legal system for market entry and exit of private hospitals, improving a system of supervision, and monitoring and evaluation of private hospital operation and performance.

摘要

在过去十年间,中国私立医院市场经历了快速增长,如今私立医院的数量比公立医院多出一倍。本政策分析运用现有数据和文献,对中国迅速变化的医院市场进行分析,找出私立医院快速增长带来的主要挑战,并提出建议,以确保中国私立医院未来的可持续发展。我们的分析表明,尽管私立医院数量超过公立医院,但公立医院的门诊量和住院量仍然更高,而私立医院的人均支出更高。私立医院发展面临的主要挑战包括政府财政支持有限、税收负担高、劳动力招聘和留用困难、政府监管不力以及公众信任度下降。应对这些挑战的建议包括向私立医院开放政府合同招标、建立允许私立医院加入国家医疗保险计划的制度、减轻私立医院的税收压力、为私立医院的市场准入和退出界定法律制度、完善监管体系以及对私立医院的运营和绩效进行监测与评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10753080/83a78b21d40d/gr1.jpg

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