CAJ | 학술논문

公立医院改革是新医改面临的难点之一.北京市通过试点探索“两个分开,三个机制”,即实现管办分开和医药分开,建立财政价格补偿调控机制、医疗保险调节机制和医院法人治理运行机制,建立以医疗服务质量、效率和满意度为核心的新的管理体制、运行机制和医疗服务模式.医药分开直接带来了药占比下降、门诊次均费用下降和患者个人负担下降,以及患者满意度提升、服务质量提升及医生和医院收益的提升；同时,医药分开间接带来了管理效益；对法人治理结构的认可逐渐趋同；便民惠民举措走向服务模式创新.
공립의원개혁시신의개면림적난점지일.북경시통과시점탐색“량개분개,삼개궤제”,즉실현관판분개화의약분개,건립재정개격보상조공궤제、의료보험조절궤제화의원법인치리운행궤제,건립이의료복무질량、효솔화만의도위핵심적신적관리체제、운행궤제화의료복무모식.의약분개직접대래료약점비하강、문진차균비용하강화환자개인부담하강,이급환자만의도제승、복무질량제승급의생화의원수익적제승；동시,의약분개간접대래료관리효익；대법인치리결구적인가축점추동；편민혜민거조주향복무모식창신.
Public hospitals reform is a key roadblock for the ongoing health reform.By means of such experiments as "Three openings and three mechanisms",Beijing is practicing a separation of hospital regulation and management and separation of clinic and pharmacy,while building the mechanism of financial subscription for pricing,that of medical insurance adjustment,and that of hospital corporate governance.These measures aim at building a new management structure,operation mechanism and medical service model focusing on quality of care,efficiency and satisfaction.Separation of clinic and pharmacy has lowered drug proportion,average outpatient expense and out of-pocket payment of patients,as well as producing higher patient satisfaction,quality of care and hospital income.Other benefits include better management efficiency indirectly caused by separation of clinic and pharmacy,higher acceptance of the corporate governance,and service model innovation to better serve the people.