中國醫院經營面臨的主要問題及對策

The Management of Hospitals in China: Problems and Solutions

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.

即將到來的新世紀，使中國醫院經營面臨著許多新的問題和嚴峻挑戰。首先，醫學教育與知識經濟的發展很不適應。其次，醫院設備與社會需要很不適應。第三，醫院經營模式與市場運行很不適應。第四，醫療服務模式與人口結構變化很不適應。第五，醫務勞動補償模式與醫務勞動消耗很不適應。

醫院經營面臨的上述問題是涉及國家與醫院兩個方面多層次的發展戰略與策略的問題，也是涉及全國各行各業和廣大人民切身利益的問題。解決問題的根本出路在於改革。首先，應真正解放思想和更新概念，擺正衛生事業在國民經濟和社會發展中的地位。第二，應改革醫學教育制度和內容，把醫學高科技教育作為學位教育和繼續教育的重點；同時搞好人事制度改革。第三，應積極地引進高新技術設備，努力提高醫院基本設施和診療儀器的現代化水平。第四，應盡快改革醫院經營體制，建立和完善新的經營模式與經營機制。為此，應着重搞好醫院布局和組織結構調整，以及醫療服務結構的調整；實行醫院的所有權與經營權分離，讓醫院法人組織和法定代表依法自主經營；按照市場經濟規律的要求，建立和完善醫院經營的動力機制、醫療技術機制、自我約束調控機制、法人領導機制。第五，應改革醫療衛生服務體制，建立適應人口結構和疾病譜變化的新的防治服務模式。為此，應擴大預防工作範圍和擴大保健人群範間，建立醫院、社區、家庭相結合的醫療衛生保健服務模式。

At the threshold of a new millennium, China's hospitals face a series of problems in their management. This essay attempts to analyze these problems and explore appropriate solutions to them.

First, the contemporary Chinese pattern of medical education is not suitable to the rapid growth of medical knowledge. Ever increasing new theories, methods, and technologies in diagnosis, therapeutics, and prognosis promote the quality of medical care tremendously. However, most health care professionals in China's hospitals are unable to follow up-to-date developments of medical information. Very few medical scientist s or physicians in China's medical care field are recognized as leading or authoritative in the world. The solution to this problem calls for an emphasis on and respect for the values of human resources in medicine, improvement of current medical education, and establishment of a mechanism for reeducating medical professionals.

Second, the current pattern of hospital management is not suitable to the market. The manner of hospital management in China is the product of China's central-planning mode of economy. Each hospital belongs to a central or local government, or to a state-owned enterprise.

It does not have power to make decisions about its own management. Neither does it care about cost-benefit balancing because hospital financing relics entirely on government revenue. However, new problems have occurred during Chin's transition to a free market economy from the centrally-planned economy since the 1980s. Though many enterprises have been allowed to manage themselves according to the circumstances of the market, hospitals have been emphasized as welfare providers that cannot be allowed to make money. The government continues to set strict low prices for medical services and, at the same time, does not provide sufficient financing to hospitals. As a result, hospitals have to make their ends meet by increasing unnecessary medication prescriptions and overusing high-technology diagnostic and therapeutic instruments. Overtreatment and waste in hospital care have generated universal complaints. Accordingly, serious reform must be made in the direction of appropriately adjusting the ownership of hospitals as well as changing the ways of hospital management so that they can adapt themselves to the need of the health care market.

Finally, there are other serious problems involved in China's hospital management. These problems are multi-faceted. For instance, medical facilities and instruments have not been up-to--dated and cannot meet the needs of patients in medical care, the structure of hospital services does not suit the need of the ever-increasing numbers of senior citizens in China, etc. The only way to resolve these problems is reform. This requires ordinary Chinese citizens as well as Chinese leadership to free themselves from the restrictions of the previous centrally-planned economic theory and to seek a new health care model.

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