县级公立医院的治理型市场化改革模式创构

模式的选择关系到县级公立医院改革结果的成败。依据公益性和积极性的关系和权重,县级公立医院主要存在两种改革模式,第一种是绩效性行政化改革模式：公益性和积极性均衡化改革模式;第二种是治理型市场化改革模式：积极性和公益性均衡化改革模式。治理型市场化改革模式是县级公立医院综合改革的必然选择。县级公立医院治理型市场化改革模式,以医药卫生费用虚高为基本假设,以医疗保险补偿机制为后续制度,以医疗保险控费机制为关键制度。医疗保险预付费方式是县级公立医院治理型市场化改革模式的支点,预付费方式不仅可以撬动公立医院管理体制创新,也可以撬动公立医院运行机制重构。

Creation of Managed Market Reform Mode of County-level Public Hospitals

The choice of reform mode has a great impact on the result of county-level public hospitals reform. On the basis of the relationship and order of public interest and enthusiasm, there are mainly two kinds of reform mode of public hospitals, the first is the performance administration reform mode; second kind is the managed market reform mode. Managed market reform mode of county-level public hospital is based on the basic assumption of medical and virtual high health costs, on follow-up system of medical insurance compensation mechanism, and on the key system of the medical insurance cost control mechanism. Medical insurance prepaid mode is the fulcrum of managed market reform mode of county level public hospital. Prepaid mode can not only innovate the management system, but also can reconstruct the operating mechanism