电子科技大学学报（社会科学版）
電子科技大學學報（社會科學版）
전자과기대학학보（사회과학판）
Journal of University of Electronic Science and Technology of China (Social Sciences Edition)
2015年
5期
5-11
,共7页
政事分开%公立医院%法人治理%多中心治理
政事分開%公立醫院%法人治理%多中心治理
정사분개%공립의원%법인치리%다중심치리
separating public service units from government%public hospital%corporate governance%polycentric governance
总体来看,我国公立医院自主权呈不断扩大态势,多数处于"预算制组织"与"自主化组织"之间.根据决策权在政府与公立医院间的分配情况,中国公立医院与政府间关系存在着三种类型:政医不分、政医分离、政医分开不分离.政医不分与政医分离两种类型的具体表现形式有公立医院不自主、依附式自主、膨胀式自主与萎缩式脱离.研究发现,中国公立医院治理中存在政医不分、政医分离、办医职能分散于政府以及政府与公立医院以及公立医院内部的委托代理问题.对此,提出"政医分开不分离",将以"法人治理结构"为核心的制度安排作为调整政府与公立医院关系的抓手,提出基于多中心治理理论的公立医院法人治理结构、制衡与激励约束机制.
總體來看,我國公立醫院自主權呈不斷擴大態勢,多數處于"預算製組織"與"自主化組織"之間.根據決策權在政府與公立醫院間的分配情況,中國公立醫院與政府間關繫存在著三種類型:政醫不分、政醫分離、政醫分開不分離.政醫不分與政醫分離兩種類型的具體錶現形式有公立醫院不自主、依附式自主、膨脹式自主與萎縮式脫離.研究髮現,中國公立醫院治理中存在政醫不分、政醫分離、辦醫職能分散于政府以及政府與公立醫院以及公立醫院內部的委託代理問題.對此,提齣"政醫分開不分離",將以"法人治理結構"為覈心的製度安排作為調整政府與公立醫院關繫的抓手,提齣基于多中心治理理論的公立醫院法人治理結構、製衡與激勵約束機製.
총체래간,아국공립의원자주권정불단확대태세,다수처우"예산제조직"여"자주화조직"지간.근거결책권재정부여공립의원간적분배정황,중국공립의원여정부간관계존재착삼충류형:정의불분、정의분리、정의분개불분리.정의불분여정의분리량충류형적구체표현형식유공립의원불자주、의부식자주、팽창식자주여위축식탈리.연구발현,중국공립의원치리중존재정의불분、정의분리、판의직능분산우정부이급정부여공립의원이급공립의원내부적위탁대리문제.대차,제출"정의분개불분리",장이"법인치리결구"위핵심적제도안배작위조정정부여공립의원관계적조수,제출기우다중심치리이론적공립의원법인치리결구、제형여격려약속궤제.
Overall, the autonomy of China's public hospitals extends continuously, most of which are nearly between budgeting organization and autonomous organization. According to the distribution of decision-making powers between the government and the public hospital, the paper puts forward three kinds of relationship type: the public hospital being entangled with the government, the public hospital breaking away from the government, and separating the public hospital from the government with organic connection. The relationship of entanglement type manifests as affiliated administration and restricted dependent autonomy. The detachment type manifests as inflated autonomy and atrophic detachment. A series of incurred problems and contradictions originate from such problems as the entanglement, the detachment, the principal-agent chain between the government and the public hospital, and the hospital building functions dispersing in various government departments and the fragmentation of external governance in the course of public hospital governance. To solve these problems the paper puts forward separating the public hospital and not breaking away from the government, taking the institutional arrangement centering the corporate governance structure as the grasp to readjust the relationship between the government and the public hospital. Based on the polycentricity governance theory, the paper designs and analyzes the corporate governance structure of public hospitals, the check-and-balance system, and the incentive-restraint mechanism.
