Reform Exploration And Optimization Study Of Public Hospital Governance Structure In Zhejiang

From the view of the supply side of health care,public hospitals from all over the world play a vital role,therefore,the mode of public hospital reform about the organizational structure and management has been the important reform content across the world.Since China’s reform and opening up,public hospital effective motivation and promoting the reform of management system and organizational structure optimization has always been the key to policy in the field of medical and health in China,the new medical reform in China(hereinafter referred to as the "new medical reform")promots the reform of the governance structure of public hospitals as the priority among priorities.It is the key to the current reform of public hospitals that how to provide medical services in the better optimize service process,and reduce unnecessary manual labour、money、 material consumption,in order to solve the problem ofthe difficulty and high cost of getting medical treatment,improve quality and benefit of medical service supply,and fully stimulate the vitality of the development of public hospitals.This study takes the change of the overall operating environment of public hospitals in China as a clue,focusing on the practice model of the governance structure reform of public hospitals in Zhejiang for many years.Through related research reports and field visits and combined with the work experience of their own hospitals,the research background,purpose and research ideas of the problems are clarified.On the basis of the methods of literature analysis,comparative analysis,case analysis,questionnaire investigation and qualitative and quantitative analysis,the defects of the traditional management system and operating mechanism of public hospitals in China are analyzed,and then the exploration of the reform of the governance structure of public hospitals in Zhejiang Province in the last 20 years is systematically combed.It also compares and evaluates the effects of several management models,summarizes the problems and deficiencies in the reform of the governance structure of public hospitals in Zhejiang province.On this basis,from local to the whole,the typical practical experience of the reform of public hospitals in all parts of the country is compared and analyzed.In the end,from the perspective of establishing the effective incentive of public hospitals,the path and relevant suggestions of the reform and optimization of the governance structure of public hospitals in Zhejiang are put forward.This study holds that the three forms of the reform of the governance structure ofpublic hospitals in Zhejiang Province,namely the "board of directors" governance model,regional medical group model and the public hospital entrustment management model.The three forms have their advantages and disadvantages,but the governance model of the public hospital Council is the most suitable promotion and the least resistance to reform.In order to optimize the governance structure reform of public hospitals in Zhejiang Province,we should focus on the two paths from outside and inside.The optimization path of the reform of external governance structure is to change the government’s functions,to promote the separation of management and management,to increase the government’s financial input to public hospitals,to perfect the compensation mechanism and to improve the external supervision system of public hospitals.The stakeholders cooperate with each other is also straighten out the supervision responsibility.The optimization path of the reform of internal governance structure is to perfect the system of the appointment of the president of the public hospital and the performance appraisal system,to establish the system of the Council to optimize the allocation and exercise of the decision-making power,to perfect the internal supervision and to improve the internal incentive and restraint mechanism in the public medical hospital.It is believed that the optimization of external governance structure and internal governance structure is dialectical unity.The internal governance structure should provide conditions through external governance structure.The external governance structure should play a role through internal governance structure.Both of them interact and interact with each other,so that the external environment and hospital organization structure should be closely coordinated.In order to promote the healthy development of public hospitals,we must realize systematic reorganized.