【摘要】：改革開(kāi)放以來(lái)，我國(guó)經(jīng)濟(jì)高速發(fā)展，，人均收入水平顯著提高。伴隨而來(lái)的是我國(guó)的經(jīng)濟(jì)發(fā)展方式也在實(shí)現(xiàn)著新階段的跨越，已經(jīng)從單純的追求經(jīng)濟(jì)總量和發(fā)展速度轉(zhuǎn)向追求總量、質(zhì)量的同步提升，實(shí)現(xiàn)經(jīng)濟(jì)又快又好發(fā)展。 隨著生活水平的提高，對(duì)于當(dāng)代公共服務(wù)的數(shù)量和質(zhì)量，人民群眾的要求也越來(lái)越高,人本價(jià)值也成為了人民思考的主要問(wèn)題。越來(lái)越多的關(guān)注焦點(diǎn)放到了生活質(zhì)量和與自身密切相關(guān)的民生問(wèn)題，這其中尤為突出的是醫(yī)療衛(wèi)生。 “看病難、看病貴”問(wèn)題一直是我國(guó)的熱點(diǎn)問(wèn)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(guān)心的是公平與效率。我國(guó)目前的公共醫(yī)療服務(wù)主要是通過(guò)公立醫(yī)院提供的，公立醫(yī)院是政府實(shí)現(xiàn)基本公共服務(wù)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(biāo)，單靠市場(chǎng)化的運(yùn)作難以實(shí)現(xiàn)，需要國(guó)家給予財(cái)政方面的支持。 2009年4月,國(guó)務(wù)院公布了《中共中央國(guó)務(wù)院關(guān)于深化醫(yī)藥衛(wèi)生體制改革的意見(jiàn)》。一定程度上推進(jìn)了我國(guó)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(guó)公立醫(yī)院仍然存在著政府責(zé)任缺失問(wèn)題。具體表現(xiàn)為：政府責(zé)任定位模糊；公益性越來(lái)越淡化；政府財(cái)政投入不足且經(jīng)費(fèi)使用效率低；缺乏科學(xué)有效的補(bǔ)償機(jī)制。如沒(méi)有統(tǒng)一的補(bǔ)償標(biāo)準(zhǔn)、補(bǔ)償方式單一、支付控費(fèi)手段欠缺；公立醫(yī)院布局不合理；政府對(duì)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(dǎo)作用。 本文以政府責(zé)任視角研究新醫(yī)改背景下我國(guó)公立醫(yī)院的改革。開(kāi)篇先對(duì)文章的研究背景做了闡述，并通過(guò)整合國(guó)內(nèi)外的研究文獻(xiàn)，歸納總結(jié)了國(guó)內(nèi)外學(xué)者的研究現(xiàn)狀。接下來(lái)，對(duì)公立醫(yī)院改革的政府職責(zé)進(jìn)行理論基礎(chǔ)上的分析，并對(duì)公立醫(yī)院相關(guān)概念、市場(chǎng)與政府職責(zé)的內(nèi)容進(jìn)行界定。 再者，從我國(guó)醫(yī)改過(guò)程中政府責(zé)任演化歷程和財(cái)政支持公立醫(yī)院模式的變化兩個(gè)方面，縱向分析中國(guó)公立醫(yī)院改革中政府責(zé)任的變化。由此引出我國(guó)現(xiàn)階段存在的政府責(zé)任缺失問(wèn)題。再通過(guò)對(duì)政府責(zé)任缺失問(wèn)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(shí)緊迫性。接下來(lái)，分析總結(jié)國(guó)外政府支持公立醫(yī)院的經(jīng)驗(yàn)和啟示、以及我國(guó)子長(zhǎng)縣公立醫(yī)院試點(diǎn)改革經(jīng)驗(yàn)。本文的最后，提出我國(guó)政府支持公立醫(yī)院的相關(guān)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(xué)位授予單位】：河北經(jīng)貿(mào)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R197.3

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前2條

1 馬銀華;專科公立醫(yī)院運(yùn)行機(jī)制改革研究[D];吉林大學(xué);2015年

2 張金;基于社會(huì)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(xué);2015年

本文編號(hào)：2475086