通过诠释科斯定理的3种表述方式并引用部分国际经验,说明国有医院产权制度改革的关键是产权清晰和减少交易成本,产权改革并不必然导致私有化。而国有医院因为多级委托—代理,使责任不能具体落实,导致产权不清晰。建议通过市场微观调控和政府宏观调控两方面来进行产权改革。政府应该根据区域卫生规划来确定医疗机构设置规划和布局,搞好医院分类管理改革,并逐步完善相应的配套政策与法规。 By interpreting the three expressions of Coase’s theorem and citing some international experience, the key to the reform of the ownership system of state-owned hospitals is clear property rights and reduced transaction costs. Property rights reform does not necessarily lead to privatization. The state-owned hospitals, because of the multi-level commission-agent, have made it impossible to implement the responsibilities, resulting in unclear property rights. It is suggested that the property rights reform be carried out through two aspects of market micro-regulation and government macro-control. The government should determine the planning and layout of medical institutions according to the regional health plan, do a good job in the reform of hospital classification management, and gradually improve the corresponding supporting policies and regulations.