本文關(guān)鍵詞： 公立醫(yī)院 法人治理模式 比較 評(píng)價(jià) 江蘇省　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：公立醫(yī)院改革一直是衛(wèi)生研究領(lǐng)域的重要課題之一,在我國(guó),公立醫(yī)院作為醫(yī)療服務(wù)的主體,承擔(dān)著重要的責(zé)任。因此,如何把握公立醫(yī)院改革的方向和力度是改革成功的關(guān)鍵。新醫(yī)改以來(lái),國(guó)家已多次出臺(tái)相關(guān)政策、指導(dǎo)意見(jiàn),強(qiáng)調(diào)推動(dòng)公立醫(yī)院法人治理改革,但當(dāng)前公立醫(yī)院法人治理改革陷入了困境,這不僅不利于公立醫(yī)院的自我發(fā)展,甚至影響醫(yī)療衛(wèi)生領(lǐng)域改革的整體效果。論文立足于江蘇公立醫(yī)院法人治理改革實(shí)踐,首先,對(duì)江蘇已有的四種公立醫(yī)院法人治理模式進(jìn)行定性比較并基于新公共管理理論探討公立醫(yī)院法人治理模式從公益性和效率兩方面均衡評(píng)價(jià)的思路;其次,通過(guò)TOPSIS法與數(shù)據(jù)包絡(luò)分析法(DEA)分別對(duì)江蘇省不同法人治理模式的醫(yī)院進(jìn)行公益性和效率兩方面評(píng)價(jià);最后,基于公益性和效率評(píng)價(jià)結(jié)果,提出推進(jìn)江蘇公立醫(yī)院法人治理改革的對(duì)策措施,為深化公立醫(yī)院改革提供參考借鑒與實(shí)踐指導(dǎo)。論文就上述問(wèn)題開(kāi)展研究,探討江蘇省公立醫(yī)院法人治理模式的比較與評(píng)價(jià)研究。論文所作研究包括以下幾個(gè)方面:(1)通過(guò)文獻(xiàn)綜述,系統(tǒng)地梳理了公立醫(yī)院法人治理、公立醫(yī)院公益性評(píng)價(jià)和公立醫(yī)院效率評(píng)價(jià)的相關(guān)研究;(2)結(jié)合專家咨詢結(jié)果,對(duì)不同法人治理模式從多角度進(jìn)行定性比較分析,以期從理論上得出較優(yōu)法人治理模式;(3)通過(guò)專家咨詢法確立公益性評(píng)價(jià)指標(biāo)體系,運(yùn)用TOPSIS法和RSR法對(duì)24家江蘇省地級(jí)市綜合性三甲醫(yī)院進(jìn)行公益性評(píng)價(jià);(4)綜合運(yùn)用聚類分析、相關(guān)分析與變異系數(shù)法篩選投入—產(chǎn)出指標(biāo),再運(yùn)用數(shù)據(jù)包絡(luò)分析法(DEA)對(duì)24家樣本醫(yī)院效率進(jìn)行評(píng)價(jià)。通過(guò)理論與實(shí)證分析,論文得出江蘇公立醫(yī)院公益性普遍不高,且不同法人治理模式的醫(yī)院公益性評(píng)價(jià)結(jié)果不同,其中董事會(huì)型模式的醫(yī)院效果較差,實(shí)行行政分權(quán)與內(nèi)部治理型樣本醫(yī)院公益性效果較好,理事會(huì)模式下的樣本醫(yī)院公益性評(píng)價(jià)結(jié)果最優(yōu)。同時(shí),江蘇四種法人治理模式下的醫(yī)院效率評(píng)價(jià)結(jié)果不同,實(shí)行理事會(huì)型模式醫(yī)院效率最優(yōu),董事會(huì)型和行政分權(quán)型醫(yī)院其次,內(nèi)部治理型醫(yī)院最低。據(jù)此,論文提出推進(jìn)江蘇公立醫(yī)院法人治理改革的政策建議,即需要繼續(xù)加大政府部門對(duì)公立醫(yī)院的衛(wèi)生投入;加快轉(zhuǎn)變政府職能,落實(shí)政府監(jiān)管職能;積極進(jìn)行公立醫(yī)院法人治理結(jié)構(gòu)改革,優(yōu)先選擇理事會(huì)模式;建立與完善公立醫(yī)院決策機(jī)制、監(jiān)督機(jī)制與激勵(lì)機(jī)制;建立完善的院務(wù)信息公開(kāi)系統(tǒng);創(chuàng)造良好外部環(huán)境,推進(jìn)公立醫(yī)院改革。
[Abstract]:The reform of public hospitals has always been one of the important topics in the field of health research. In our country, public hospitals, as the main body of medical services, bear important responsibilities. How to grasp the direction and strength of public hospital reform is the key to the success of the reform. Since the new medical reform, the state has issued several related policies and guidance opinions, emphasizing the promotion of public hospital corporate governance reform, However, the current reform of corporate governance in public hospitals is in a difficult position, which is not only unfavorable to the self-development of public hospitals, but also affects the overall effect of the reform in the field of medical and health care. This paper is based on the reform practice of corporate governance in Jiangsu public hospitals. This paper makes a qualitative comparison of four kinds of public hospital corporate governance models in Jiangsu Province, and discusses the thinking of public hospital corporate governance model in terms of public welfare and efficiency based on the new public management theory. Secondly, Through TOPSIS method and data envelopment analysis method, the author evaluates the public welfare and efficiency of hospitals in different corporate governance models in Jiangsu Province, and finally, based on the results of public welfare and efficiency evaluation, This paper puts forward countermeasures and measures to promote the reform of legal person governance of public hospitals in Jiangsu Province, and provides reference and practical guidance for deepening the reform of public hospitals. This paper discusses the comparison and evaluation of the governance model of public hospital legal person in Jiangsu Province. The research in this paper includes the following aspects: 1. Through literature review, this paper systematically combs the governance of legal person in public hospital. Combined with the results of expert consultation, this paper makes a qualitative comparative analysis of different corporate governance models from multiple angles. In order to get the better corporate governance model in theory, we can establish the public welfare evaluation index system by expert consultation method, and use TOPSIS method and RSR method to evaluate the public welfare of 24 prefecture-level comprehensive third-class hospitals in Jiangsu Province and make comprehensive use of cluster analysis. Correlation analysis and coefficient of variation are used to screen input-output indexes, and data envelopment analysis (DEAA) is used to evaluate the efficiency of 24 sample hospitals. Through theoretical and empirical analysis, the paper concludes that the public welfare of Jiangsu public hospitals is generally not high. The evaluation results of public welfare of hospitals with different corporate governance models are different, among which the hospital effect of board of directors model is poor, and the public welfare effect of sample hospitals with administrative decentralization and internal governance is better. At the same time, the evaluation results of hospital efficiency under the four kinds of corporate governance models in Jiangsu are different. The hospital efficiency of the board of directors model and the administrative decentralization hospital is the second. Therefore, the paper puts forward some policy suggestions to promote the reform of the corporate governance of public hospitals in Jiangsu Province, that is, to continue to increase the health investment of government departments in public hospitals, to speed up the transformation of government functions, and to implement the functions of government supervision. Actively carrying out the reform of the corporate governance structure of public hospitals, giving priority to the choice of the mode of board of directors, establishing and perfecting the decision-making mechanism, supervision mechanism and incentive mechanism of public hospitals, establishing a perfect open information system of hospital affairs, creating a good external environment, We will promote the reform of public hospitals.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.3

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