县级公立医院发展的体制性障碍及破除路径

摘要

Substantially, medical insurance payment methods is an medical resources allocation mechanism and it can promoting system and mechanism reform in public hospital. Medical insurance post payment system as the pivot, performance based administrative system of public hospital can be established. And medical insurance pro-payment system as the pivot, governance oriented market mechanism of public hospital can be established. In view of coherence with value, institution and goal, two types of public hospital system and mechanism are compared and the author agree with governance oriented market mechanism.%　　从供求矛盾是县域医药卫生事业的主要矛盾、行政管制是县级公立医院发展的体制性障碍两方面分析了目前我国县级公立医院的改革形势，认为优化行政管制和破除行政管制是克服残缺型行政管制缺陷的两条主要路径，以治理型市场化为主要内容的破除行政管制路径符合县域医药卫生事业发展的主要矛盾，而且有利于实现公益性和积极性并重和均衡，也是县级公立医院管理体制改革的必然选择。