2017年4月,北京市医院管理局(以下简称医管局)下发《医学学科协同发展中心试点工作实施方案》,选择在儿科和消化内科等学科具有全国领先优势的两家市属医院试点医学学科协同发展中心(以下简称协同中心)建设,辐射带动其他市属医院儿科和消化内科的整体发展水平,初步建立适合市属医院的协同发展体系,进一步提高管理水平、创新工作模式、完善运行机制以及绩效产出、建立质量评估和持续改进体系.协同中心定位于区域协同发展,又不同于传统的分级诊疗体系和区域医学中心,是医管局在充分梳理市属医院学科发展特点,并结合自身集团化管理优势的基础上提出的一种有机协同、全面发展且相对紧密的协同创新体系,对提高市属医院整体学科水平有重要意义,报告如下.

根据《医院财务制度》和《医院会计制度》(2010版)以及国家关于加强公立医院财务管理和成本控制的系列改革政策,结合北京市以政府主导开展公立医院病种成本核算试点情况,总结效果,分析现存问题,提出完善性管理建议.

With the advancement of the health reform and development of medical services,and performance evaluation of fine management,have become a major means to regulate medical services, improve quality of medical services, and promote healthy functioning of hospitals. The Hospital Authority worked out the performance evaluation standards for municipal hospitals. Setup of such financial evaluation indices as cost control rate,basic operation and healthcare materials for 10 000 yuan medical revenue,per-capita income and expenditure balance,implementation of fiscal input,and asset turnover.Finance and asset management of municipal public hospitals were subject to a general assessment and comparative analysis. Assessment results were linked to the hospital ’s annual performance bonuses.This enables the financial indicators and assessment to play a key role for hospitals to reduce costs,improve efficiency and strengthen fine management. Hospitals were encouraged to achieve balanced income and expenditure, surpluses, asset efficiency, performance budgeting, cost controls,decent financial operations.

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.

对北京市目前"看病难、看病贵"的成因进行了初步分析,并针对相关问题提出了缓解北京市"看病难、看病贵"问题的政策建议,以期缓解北京市"看病难、看病贵"的问题.

针对北京市目前"看病难、看病贵"的成因,提出了缓解北京市"看病难、看病贵"问题的政策建议.建议调整现有的卫生资源分布,建立多层次医疗服务体系,发展社区卫生服务,发展农村卫生事业,改进政府卫生投资模式,推进医疗服务付费制度改革,改革公立医疗机构管理体制,加强医院内部管理,改进药品和医疗器材购销及医疗服务价格管理,扩大基本医疗保险覆盖面等,以期缓解北京市"看病难、看病贵"的问题.