我国大型公立医院的治理结构.pdfVIP

摘要 纵观世界各国公立医院发展历程中，都面临着效率运行低下这一世界性难 题。解决这一课题的关键不仅仅是增加政府财政支出，更重要的是探索新的经 营运行机制，促使公立医院的内外部治理结构中各方相互制衡、相互监督。我 国新一轮医疗卫生体制改革中，公立医院管理体制改革是重点环节。因此，在 这样的情况下，对规模庞大、管理复杂的大型公立医院的治理结构进行剖析研 究，提出完善其治理结构的对策，具有十分重要的理论意义和现实意义。 本文从法人治理结构和利益相关人的理论入手，结合国际比较研究的经验 和我国大型公立医院治理结构运行现状，分析了在大型公立医院中现存治理结 构的主要问题和试点地区探索模式的可行性，进而提出了完善我国大型公立医 院治理结构的建议和对策。即在坚持公益性方向的原则下，建立出资人制度合 理界定政府职能，从政事分开过渡到法人治理结构，同时充分发挥利益相关人 的约束制衡作用，构建多主体监督体系，并实施相关的配套支持政策。 本文提出的建议是建立在相关理论分析和政策分析的基础之上，具有很强 的针对性。但受时间和精力所限，本人的研究还不够深入，相关理论分析可能 并不全面，提出的完善对策仍需要可操作性的执行细节。 关键词：大型公立医院；法人治理结构；利益相关人 1 Abstract We can find the inefficient operation has become a common problem in public hospitals in the world. The key to resolving this issue is not only to increase government expenditure, and more importantly, to explore new business operation mechanism. The new mechanism favors Mutual supervision and balance of power among the parties in the internal and external governance structure. In the new round of medical and health system reform, public hospitals reform is a key part. Therefore, in such circumstances, to analyze on the governance structure of major and complexity public hospitals, then to propose improved measures, is of great theoretical and practical significance. Based on corporate governance and stakeholder theories, the article has analyzed the major governance problems existing in major public hospital and the feasibility of pilot zone model. Then proposed suggestions and countermeasures to improve the governance of major public hospitals. That is, establishing the reasonable investor to define government functions. First separate the functions of government from hospitals, then realize the corporate governance. Meanwhile giving full play to the stakeholders bound