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某公立医院跨省托管后医疗服务经济学评价及满意度分析

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某公立医院跨省托管后医疗服务经济学评价及满意度分析

作者:杨哲张士华任晓燕

来源:《中国医药导报》2017年第34期

[摘要] 基于跨省之间公立医院托管的实施,从医院成本、财政投入、业务收入、保险补偿、经济管理效益以及职工福利待遇等方面对托管前后的变化进行对比分析,并采用李克特5级评分量法对陕西省安康市白河县中医医院的满意度进行分析,为公立医院改革提供政策建议。医联体建立后,医院的业务收支结余有了大幅度改善,参保者的次均费用明显高于自费患者,职工福利有了显著改善。管理者在分配制度方面的满意度最低,其次是人事制度;职工在工资福利待遇的满意度最低,未来发展情况和工作环境的满意度均较高;患者在医护人员的服务态度方面,满意度提高非常明显。

[关键词] 公立医院;跨省托管;医疗服务经济学评价;满意度分析

[中图分类号] R197 [文献标识码] A [文章编号] 1673-7210(2017)12(a)-0141-05

[Abstract] Compare and analyze the changes before and after the trusteeship from the aspects of hospital cost, financial input, business income, insurance compensation, economic management benefits, and employee benefits. And the satisfaction of Baihe County Hospital of Traditional Chinese Medicine in Shaanxi Province was analyzed by Likert scale score, in order to provide policy suggestions for the public hospital. It is observed that the balance of business is income and the expenditure has been improved after trusteeship. The cost of insurance for the insured is higher than the self-funded patients, and the welfare of the staffs has been significantly improved. The lowest satisfaction of managers is the distribution system, the second is the personnel system. The lowest satisfaction of workers is the salary and welfare treatment, the satisfactions of future development and work environment are high. The service attitude of medical staff is significantly improved in patients′ satisfaction.

[Key words] Public Hospital; Trans-provincial trusteeship; Medical service economics evaluation; Satisfaction degree analysis

公立医院是提供医疗服务的主体力量,是体现公益性、解决基本医疗、缓解人民群众看病贵看病难的主要机构[1]。2009年新医改方案明确提出“推进公立医院改革是新医改方案确定的五项重点改革内容之一”[2],并指出“鼓励城市三级医院与县级医院采取合作、托管、组建医联体等多种方式,建立长期稳定的分工协作关系,提高县级医院的管理和服务水平”[3]。

医院托管,是通过契约形式,受托方有条件地管理和经营委托方的资产,并实现资产的保值增值,从而使大型公立医院优质的医疗资源向基层合理流动,快速提升中小型医院的技术水