本文選題：公私合作伙伴關(guān)系(PPP)　切入點：私人融資計劃(PFI)　出處：《吉林大學》2017年碩士論文　論文類型：學位論文

【摘要】：提供優(yōu)質(zhì)、便利的醫(yī)療服務是每個國家都關(guān)注的問題。但是,隨著人們對醫(yī)療服務需求的增加以及人口老齡化的加劇,僅依靠政府的人力、物力、財力來滿足顯得日漸力不從心。世界衛(wèi)生組織鼓勵各國在衛(wèi)生工作上引入市場的力量,越來越多的國家在提供醫(yī)療服務方面與社會資本合作。英國在二戰(zhàn)后建立了國民醫(yī)療服務體系(National Health Service,NHS),這種廣覆蓋、高福利性質(zhì)的醫(yī)療體系很快令國家財政不堪重負,醫(yī)療服務的質(zhì)量也急劇下降。二十世紀90年代,英國將PPP(Public-Private Partnership,公私合作伙伴模式)引入醫(yī)療服務領(lǐng)域。由私營部門對醫(yī)院進行設(shè)計、改造、維護,并提供非核心醫(yī)療服務,政府向私營部門支付費用購買服務。這種利用私營部門資金、管理優(yōu)勢的模式使得英國的醫(yī)療設(shè)備短時間內(nèi)得到改善、工程按時完工率以及計劃成本內(nèi)完工率都得到大大提升。政府由提供醫(yī)療服務轉(zhuǎn)為購買醫(yī)療服務,由辦醫(yī)院變?yōu)楣茚t(yī)院,從而有更多的精力去制定規(guī)章制度、完善醫(yī)療體系。英國在醫(yī)療PPP模式上的實踐無論是數(shù)量還是成熟度方面都是世界領(lǐng)先地位,很多國家對此進行學習、借鑒。我國在新醫(yī)改之后就鼓勵社會資本以多種方式參與提供醫(yī)療服務,2013年開始,PPP模式在我國迎來了新時期,項目數(shù)量龐大、逐漸走向規(guī)范化是這一時期的特點。在這樣的背景下,將兩者結(jié)合可以改善我國在醫(yī)療服務領(lǐng)域的些許問題。但是,相比較其他領(lǐng)域,醫(yī)療領(lǐng)域民營資本參與的積極性不高。這其中的一大原因就是我國以往在公私合作領(lǐng)域的實踐集中在水電等經(jīng)濟類基礎(chǔ)設(shè)施,在醫(yī)療服務方面缺乏示范經(jīng)驗。所以,在這種背景下,研究英國在醫(yī)療領(lǐng)域的PPP模式對我國開展醫(yī)療PPP實踐有一定借鑒作用。本文的研究方法主要有文獻分析法和案例分析法。對PPP模式的內(nèi)涵、特征以及意義等基礎(chǔ)理論分析時運用文獻總結(jié)、分析。通過對英國的一個典型醫(yī)療案例進行介紹、研究,以期從中看出得與失,成功之處與不足之處,為我國未來醫(yī)療PPP事業(yè)提供經(jīng)驗借鑒。本文的研究結(jié)構(gòu)如下:第一章闡述了本文的研究背景、意義、思路、方法,以及對國內(nèi)外的部分文獻做了概述。第二章介紹了PPP模式的定義、理論基礎(chǔ)與典型結(jié)構(gòu),接著研究了PPP模式在醫(yī)療服務領(lǐng)域的運作模式、實踐情況以及成效。第三章研究了英國醫(yī)療服務PPP模式的發(fā)展歷程以及特征。第四章對英國西米德爾塞克斯大學醫(yī)院PFI項目從操作模式、指標評估、法律依據(jù)、監(jiān)管、優(yōu)劣等方面進行了案例研究,期望從中得出英國醫(yī)療PFI項目的一些共性問題。第五章分析了英國醫(yī)療服務PPP項目隱患與挑戰(zhàn)的具體表現(xiàn)。第六章介紹了我國現(xiàn)階段醫(yī)療PPP項目的現(xiàn)狀。指出了英國醫(yī)療PFI模式對中國不完全適用的原因:中英醫(yī)療服務體系不同以及中英應用PPP模式的目的不同。而在對公立醫(yī)院的公私合作的法律政策上可以單獨設(shè)計這一點我國可借鑒的英國經(jīng)驗,另外將PPP項目的監(jiān)督職能落實到具體部門也是我國現(xiàn)階段需要學習加強的。
[Abstract]:To provide quality and convenient medical services is concerned about the problems of each country. However, with the increasing demand of medical services and increasing aging population, only rely on the government's manpower, material resources, financial resources to meet become increasingly powerless. WHO encourage countries introduced in health work on the strength of the market, more and more countries in providing medical services cooperation and social capital. The British established the national health service after World War II (National Health Service, NHS), the wide coverage, high welfare medical system quickly made national fiscal burden, quality of medical services decreased rapidly. In twentieth Century 90s, the British PPP (public-private partnership mode Public-Private Partnership) into the field of medical services. By the private sector of the hospital for the design, renovation, maintenance, and provide non core medical services Wu, the government to the private sector to pay the cost of purchase of services. The use of private sector funds, management advantages of the model makes the medical equipment short time within the UK is improved, the project completed on time and cost rate plan completion rate have been improved greatly. The government by providing medical services to purchase medical services by hospitals into tube the hospital, which have more energy to formulate rules and regulations, improve the medical practice in the medical system. PPP model of the UK both quantity and maturity are the leading position in the world, many countries are learning, reference. In our country after the new medical reform to encourage social capital to participate in a variety of ways to provide medical services, 2013 to usher in a new era of PPP mode in our country, a large number of projects, gradually standardized is the characteristics of this period. In this context, the combination of the two can be In order to improve some problems in the field of medical service in our country. However, compared with other areas, the enthusiasm of private capital to participate in the medical field is not high. One of the reason for this is our past practice in the public-private cooperation field concentrates in hydropower and other economic infrastructure, lack of demonstration experience in medical service. So, in this context, the research in the medical field PPP model has some reference for our country to carry out the practice of medical PPP. The main research methods are literature analysis and case analysis. The connotation of PPP mode, using the literature summary, analysis of characteristics and significance of the basic theory. Through a the typical case of British medical research are introduced, in order to see gains and losses, successes and shortcomings, to provide experience for China's future PPP medical career. This study is structured as follows: The first chapter describes the research background, the significance, ideas, methods, and the domestic and foreign literature are summarized. The second chapter introduces the definition of PPP model, and the typical structure of the theoretical foundation, then study the operation mode of PPP mode in the field of medical service, practice and results. The third chapter studies the development of the course of British medical service PPP mode and its characteristic. The fourth chapter of the British Schmid M Sykes University Hospital PFI project from the mode of operation, evaluation, supervision, legal basis, made a case study on the pros and cons, expect to draw some common problems of the project from the British Medical PFI. The fifth chapter analyzes the specific performance problems and challenges of medical English the PPP service project. The sixth chapter introduces the present status of health PPP project in China. It is pointed out that the cause of British Medical PFI mode is not fully applicable to the China: British Medical The application and service system of different PPP mode for different purposes. And can design this point in our country can be used for reference in the legal policy of public-private partnership in public hospitals on the British experience, will also need to learn to strengthen the implementation of supervision function of PPP project to specific departments is also our country at the present stage.

【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R199

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