本文選題：醫(yī)療改革　切入點(diǎn)：績效　出處：《浙江工商大學(xué)》2012年碩士論文

【摘要】：醫(yī)療衛(wèi)生關(guān)系我們身心健康,同時(shí)也關(guān)系我國經(jīng)濟(jì)發(fā)展的人力資本投入。從改革開放到現(xiàn)在,伴隨經(jīng)濟(jì)改革的浪潮,醫(yī)療衛(wèi)生事業(yè)也經(jīng)歷了幾次改革。由于醫(yī)療市場的特殊性,使市場的作用在醫(yī)療衛(wèi)生領(lǐng)域失靈,同時(shí)政府在醫(yī)療領(lǐng)域管制的不到位,醫(yī)療服務(wù)市場療服務(wù)供給的公平性下降和補(bǔ)償機(jī)制的扭曲等問題滋生出“以藥養(yǎng)醫(yī),以檢查養(yǎng)醫(yī),以設(shè)備養(yǎng)醫(yī)”等現(xiàn)象,至使醫(yī)療費(fèi)用的快速增長,“看病難,看病貴”成為突出的社會(huì)問題,加重了社會(huì)和個(gè)人的經(jīng)濟(jì)負(fù)擔(dān)。與此相關(guān)的是醫(yī)療事故不斷發(fā)生,醫(yī)患關(guān)系開始緊張。 在我國醫(yī)療市場上,公立醫(yī)院是醫(yī)療市場的供給主體,其醫(yī)療費(fèi)用的控制對(duì)整體醫(yī)療費(fèi)用起關(guān)鍵性作用。伴隨醫(yī)療衛(wèi)生領(lǐng)域的放開,民營醫(yī)院加大了對(duì)醫(yī)療衛(wèi)生領(lǐng)域的投資,這一方面增加供給,促進(jìn)市場競爭,提高了行業(yè)績效,但另一方面也暴露出一些問題,如醫(yī)療事故頻發(fā),醫(yī)療質(zhì)量參差不齊,也加大了公眾的負(fù)擔(dān)。世界各國圍繞醫(yī)療費(fèi)用問題對(duì)整個(gè)醫(yī)療服務(wù)體系實(shí)施改革。在其改革的過程中,往往會(huì)暴露出醫(yī)療費(fèi)用下降的同時(shí),而醫(yī)療質(zhì)量也下降的問題。 2005年7月,國務(wù)院發(fā)展研究中心課題組在《對(duì)中國醫(yī)療衛(wèi)生體制改革的評(píng)價(jià)與建議》的報(bào)告中得到的醫(yī)療體制“改革基本上是不成功”的總體評(píng)價(jià)后,新一輪的醫(yī)改拉開了帷幕,經(jīng)過多方多次的研究討論,2009年4月公布新醫(yī)改方案《中共中央國務(wù)院關(guān)于深化醫(yī)藥衛(wèi)生體制改革的意見》。新醫(yī)改方案確立了政府主導(dǎo)的基本原則,明確提出要“強(qiáng)化政府在基本醫(yī)療衛(wèi)生制度中的責(zé)任”。 本文首先從所有權(quán)理論和競爭理論上探討影響醫(yī)療費(fèi)用和醫(yī)療質(zhì)量的因素,其中,重點(diǎn)闡述所有權(quán)安排對(duì)于醫(yī)療費(fèi)用控制和醫(yī)療質(zhì)量的影響,市場競爭對(duì)于醫(yī)療費(fèi)用控制和醫(yī)療質(zhì)量的作用,并且對(duì)醫(yī)改對(duì)醫(yī)療服務(wù)行業(yè)績效的影響進(jìn)行分析。對(duì)中國現(xiàn)階段醫(yī)療服務(wù)市場的改革,分析現(xiàn)階段醫(yī)療市場的所有權(quán)格局與競爭格局,提出中國新一輪醫(yī)療衛(wèi)生體制改革,應(yīng)該進(jìn)一步對(duì)公立醫(yī)院進(jìn)行改革,調(diào)動(dòng)各類資源的積極性,降低醫(yī)療費(fèi)用,提高醫(yī)療服務(wù)質(zhì)量。應(yīng)進(jìn)一步擴(kuò)大民營資本市場準(zhǔn)入的范圍,鼓勵(lì)各種社會(huì)資本參與投資的營利性和非營利性醫(yī)療機(jī)構(gòu)的發(fā)展,促使整個(gè)醫(yī)療服務(wù)市場開展健康有序地競爭,提高醫(yī)療服務(wù)業(yè)的績效水平。
[Abstract]:Health care is related to our physical and mental health, but also to our economic development of human capital investment.Since the reform and opening up to the present, along with the wave of economic reform, the medical and health industry has also experienced several reforms.Due to the particularity of the medical market, the role of the market in the field of medical and health services has failed, and the government has failed to regulate the medical field.The decline in the fairness of medical service supply in the medical service market and the distortion of the compensation mechanism have led to the phenomenon of "keeping doctors with drugs, checking them, and raising doctors with equipment." this has led to a rapid increase in medical costs, and "it is difficult to see a doctor."Expensive medical treatment "has become a prominent social problem, increasing the social and personal economic burden."Related to this is the continuous occurrence of medical accidents, the relationship between doctors and patients began to tense.In the medical market of our country, the public hospital is the main body of the medical market, and the control of its medical expenses plays a key role in the overall medical cost.With the opening of the medical and health field, private hospitals have increased their investment in the field of medical and health care. On the one hand, they increase supply, promote market competition, and improve the performance of the industry, but on the other hand, they also expose some problems, such as the frequent occurrence of medical accidents.The uneven quality of medical care has also increased the burden on the public.Countries around the world around the issue of medical costs to implement the reform of the entire medical service system.In the course of its reform, it often exposes the decline of medical cost and the decline of medical quality.In July 2005, the research group of the Development Research Center of the State Council obtained an overall evaluation of the medical system "basically unsuccessful" in its report "Evaluation and recommendations on the Reform of China's Medical and Health system".A new round of medical reform was launched. After many studies and discussions, the new medical reform plan "opinions of the CPC Central Committee and the State Council on deepening the Reform of the Medical and Health system" was published in April 2009.The new medical reform scheme establishes the basic principle of government leading, and clearly proposes to "strengthen the responsibility of the government in the basic medical and health care system".This paper first discusses the factors that affect medical expenses and medical quality from ownership theory and competition theory. Among them, it focuses on the influence of ownership arrangement on medical cost control and medical quality.The effect of market competition on medical cost control and medical quality, and the impact of medical reform on medical service industry performance are analyzed.On the reform of the medical service market in China at present, the ownership and competition pattern of the current medical market is analyzed, and the new round of medical and health system reform in China is put forward, which should be further reformed to the public hospitals.Mobilize the enthusiasm of all kinds of resources, reduce medical costs, improve the quality of medical services.The scope of market access for private capital should be further expanded, and all kinds of social capital should be encouraged to participate in the development of for-profit and non-profit medical institutions, so as to promote healthy and orderly competition in the entire medical service market.Improve the performance of the medical service industry.
【學(xué)位授予單位】：浙江工商大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R197.1;F719

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