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在过去30年中,卫生服务费用的快速增长已成为一个全球性问题。针对此问题,我国采取了以改革支付方式为主要内容的医院筹资改革。虽然每个医院都设计与实施了各自的奖金支付方式,以达到各自的目标,但有可能偏离或背离了政府的改革目的。从理论上讲,奖金制度应有助于医院提高生产效率,增强经济活力,改善社会效率。但在实际运作中,奖金制度一方面可激励医生提高生产率,提供更多的必要服务;另一方面又可能激励医生诱导病人需求,提供不必要服务。前一种情况可以达到改革的预期目的,而后一种情况显然没有达到预期目的。带着这些问题与思考,我们进行了医生支付方式改革对医院服务效率的影响研究。
In the past 30 years, the rapid increase in the cost of health services has become a global issue. In response to this problem, China has adopted a hospital financing reform with reform as the main content. Although each hospital has designed and implemented its own bonus payment method to achieve its own goals, it may deviate from or deviate from the government’s reform objectives. In theory, the bonus system should help hospitals to increase production efficiency, enhance economic vitality, and improve social efficiency. But in actual operation, the bonus system on the one hand can motivate doctors to increase productivity and provide more necessary services; on the other hand, it can motivate doctors to induce patient needs and provide unnecessary services. The former situation can achieve the intended purpose of the reform, and the latter situation obviously does not achieve the intended purpose. With these questions and reflections, we conducted a study on the effect of doctor payment method reform on hospital service efficiency.