北京市30所县级公立医院经济运行情况分析

摘要

Objective To propose on reform and development policies of county-level public hospitals in Beijing by means of investigation and analysis of their business operations to identify existing problems.Methods Quantitative,descriptive analysis and in-depth interviews were used to study business operation data from 2012 to 2014 of the 30 county-level public hospitals in Beijing,in order to learn their development trends.Results Business operations of such hospitals were found to be desirable in general.The average growth rate per annum of the revenue of county-level hospitals,traditional Chinese medicine hospitals and women-children health hospitals was 1 5.7%, 18.7%,and 1 1.0%respectively; such growth rate of their expenditure was 1 6.4%, 21.1%, and 1 5.1%respectively.Roadblocks were also found,however,namely low income of medical personnels,operations in debt,lack of subsidy channels,and the marked gap of development among such hospitals.Conclusions In view of the above-mentioned problems,the authors put forward policy suggestions as follows:to optimize the government subsidy mechanism,to improve financial supervision and internal audit of such hospitals,to reasonably raise income of the medical personnels,and to build a mutually complementary system of medical service system that is mutually complementary between urban and rural areas in terms of their functionality.%目的：通过对北京市部分区县级公立医院经济运行情况进行调研,探讨其中存在的问题,提出北京市区县级公立医院改革与发展的相关政策建议。方法对北京市30所区县级公立医院2012年至2014年运行数据进行定量及描述性分析,并进行深度访谈,了解其运行现状与发展趋势。结果北京市区县级公立医院总体经济运行情况良好,2012年至2014年,区(县)医院、中医医院、妇幼保健院总收入年均增长率分别为15.7%、18.7%、11.0%；总支出年均增长率分别为16.4%、21.1%、15.1%。但存在医务人员工资收入水平不高、举债运营、补偿机制单一、区县公立医院间发展差异较大等问题,有待进一步解决。结论针对区县级公立医院运行中存在的问题,提出优化政府补偿机制、加强财务监管和内部审计、合理确定医务人员薪酬水平、建立功能互补型城乡医疗服务体系等政策建议。