为适应医共体这一新型医院组织模式的管理需求,迫切需要变革传统的财务管理模式.实行财务集中管理模式,是实现医共体建设目标的有效、有力支持.本文对医共体实施财务集中管理模式的必要性、实施措施和存在问题进行了初步探讨.

2011年,浙江省政府下发《浙江省县级公立医院综合改革试点指导意见》,并在年底前实施了以药品零差率为抓手的县级公立医院综合改革,本次医改的目标是“群众得实惠、医院得发展、政府得民心”.2011年12月26日,绍兴市中心医院率先启动县级公立医院综合改革试点工作,改革内容包括探索建立医院经济运行新机制,也即破除“以药补医”机制,按照医药费用“总量控制、结构调整”的原则,调整医疗服务价格,完善收费结构;加强医院的综合管理,主要是优化门急诊环境和流程、开展预约诊疗服务、深入开展“志工”活动、推广优质护理服务、开展抗菌药物临床应用管理、实施医疗费用控制策略;开展运行机制改革试点,主要是完善院长负责制、完善医院人事和收入分配制度、增强医院运行效率.

Objective: By exploring the application of outpatient and hospitalization seamless integrated hospitalization reservation system in general hospital to promote the limited beds rational,orderly and efficiency use and to maximum match patient's hospitalization demand.Method: Patient who admitted from January 1,2011 to November 30,2011 were assigned into traditional reservation group(control group) and who admitted from January 1,2012 to November 30,2012 were assigned into the informationalized reservation group(observation group).And patients who in and out of hospital due to health care costs were ruled out to ensure the scientificity and comparability of the clinical information.Main observation indices: number of hospitalizations for appointment,average length of reservation,bed utilization rate,average hospitalization days,healthcare workers’ satisfaction,patients’ satisfaction.Results:withnumberofhospitalizationsforappointmentandbedutilizationratebasicallyunchanged,therearesignificantdifferencesinaverageappointment length of hospital stay,the average hospitalization days,healthcare workers’ satisfaction,patients’ satisfaction between the observation group and the control group(P<0.01).Conclusion to make full use of information technology,and to treat patients more reasonably,efficiently,and orderly,is an important meansofproperlyresolvingthehospitalizationcontradictionandconstructingharmoniousdoctor-patientrelationship.