Studies On The Regulation Of The Conversions Of Private Medical Institutions

Objective:To understand the issues in the conversions of private medical institutions and explore the possible options. To provide reference for health policy making for regulation on the conversions of Chinese private medical institutions.Contents:The correlation theories of regulation on conversions were cited, and the content and process of regulation on conversions of American private medical institutions were summarized; the conversions of Chinese private institutions and problems in the supervision were analyzed, followed by the summary of development feature of Chinese private, and the hackle of national policies and the conduction with case study, the conversions of private medical institutions and regulatory differences of China and USA were comparatively analyzed. And policy and research suggestions were put forward thereby.Research Methods:Conceptual approach was applied to definition conversions of private medical institutions; Literature review was used to summarize the content and process of the regulation on the conversions of American private medical institutions; Case study and in-depth interview were employed in converted private medical institutions, by interviewing the hospital directors, senior managers, and executive officers of health department, and content of the interviews was analyzed by using thematic framework analysis; and comparative analysis method was used to analyze the conversions of private medical institutions and regulatory differences of China and USA.Results and Analysis:The concept for conversions of private medical institutions in China was defined, as owning to purchase(sale)、mergers(consolidation)、joint ventures and other types of reorganization, the purpose of operation of private medical institutions have to be changed, or private medical institutions operators apply for changing the purpose of operation, by which private medical institutions changes its essential orientation from non-profit to for-profit or vice versa. The necessity of governmental supervision on the conversions of private medical institutions was stated from the perspectives of the economic theory of regulation, public administration theory, game theory between private institutions and government department.The content and process of regulation for conversions of American private medical institutions were summarized. The conversions of American private medical institution were legislatively guaranteed, mainly by the common law, statutory law, federal and state laws and code. The responsibilities were set for the State Attorney General, Health Department, Insurance Department, Internal Revenue Service, and the Court and etc; the procedure for conversions, the specific application materials submitted by hospitals, the criterion approved by government department were ruled; tax-exempt status in accordance with the "standard of community benefit" of private non-profit hospitals must be checked by tax department, the asset disposal was unlike when the hospital changed orientation from non-profit to for-profit, according to different types of conversions.Conversions of Chinese private institutions were analyzed. The reasons for conversions were diversified, and the process was not standardized, the attitudes towards how to deal with the net assets differed so much among the investors. The legislation and supervision in government department was still under-developed.The conversions for private medical institutions and regulatory differences between China and USA were comparatively analyzed. Different aspects were compared about the reasons and admittance for conversions, the manner and content, as well as the transparency for regulation, and the participation level of people, to get experience reference of American.Further Discussions:Conversions of private medical institutions is definition, and regulatory discretion of government is cleared to protect the legal interest of public and conversions parties; conversions of private medical institution is short of laws, and regulation system in China, there are flaws in both external and internal structure of the governance of private medical institutions. so the principle of "non-profit" can not be guaranteed in the operation of private medical institutions, and the deep-seated reasons of the faultiness of regulatory system are discussed. Consequently, to improve the governance structure of private medical institutions is necessary, to establish the regulation system of private medical institutions is a priority, the conversions need policy support, and transparency is the objective requirement.Recommendations:The supervision departments and their responsibilities should be defined and carried out, multi-sector should take the charge of the conversions of private medical institutions, and legislation and supervision for the "non-profit" principle on private medical institution should be enhanced, the process for conversions should be standardized and the belongs of net assets should be cleared defined, the transparency of regulatory information should be emphasized.