新津县人民医院医改战略与实施
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摘要
随着2009年医改的提出,患者及家属都对这个以“实现人人享有基本医疗卫生服务”为目标的重大民生工程翘首以盼。作为这个工程中的核心部分——县级医院的发展,更是受到了所有人的瞩目。新津县人民医院始建于1942年,距今已有70年的发展历史,是新津县唯一一家大型综合县级医院。在医改的号召下,政府大力支持新津县人民医院进行医改,同时,新津县人民医院也积极实施各项发展性战略,摆脱困境,实现扭亏为盈,全面提升医院服务能力。随着医疗服务水平的提高,又有力地促进了医院的发展,实现医改的初步目标。
本文主要采用了案例分析的方法,对新津县人民医院进行了深入地研究,并参考了设计学派基本模型,使用PEST分析法从政策、经济、文化等几个方面介绍了新津县人民医院的医疗卫生环境；然后在医院现状的基础上分析了医院内部的优势、劣势、机会和挑战；再通过确立医院的医改原则和使命,明确医院的战略发展方向,提出适宜医院发展的医改具体实施措施,特别是在医院新的发展理念和精细化管理模式上更是做了很多的努力；最后对医院医改战略实施后的一些阶段性成果做了简单地介绍和说明。本文所提的医改战略,实质上是希望新津县人民医院通过实施基础设施完善、专科科室优化配置、全面服务质量提升、满意度管理、人才引进、信息化建设、文化建设等各项发展性战略来推动医院医改的实现。事实证明,新津县人民医院在实施这些战略后,确实得到了很大地发展,因此,本文的研究总结具有一定的实践意义和参考价值。
With the medical reform strategies proposed, people are highly anticipated to the major livelihood project whose goal is "Everyone will have access to basic medical and health services". As a core part of the project, the development of country hospitals is attracting everyone's attention. The people's hospital of Xinjin was founded in1942, more than70years of developing history, is the only one large-scale comprehensive country hospital in Xinjin. Under the call of medical reform, the government stepped up efforts to support country hospitals, which made the development of country hospitals have a new strong driving force. And the people's hospital of Xinjin actively implements each development strategies to overcome its predicament, realizing a profit. With the improvement of medical service level, the development of the hospital has been promoted.
This article takes the people's hospital of Xinjin as an example to have a deep research, and uses the basic model of the design school as a reference. First it introduces the external factors such as politics, economy and culture. Then based on the current situation, it analyzes the internal situation such as strengths, weaknesses, opportunities and threats. Next it indicates the direction of the hospital and the specific medical reform strategies through putting forward medical reform principles and the hospital's mission. Finally, it introduces and explains the stage results after implementing the medical reforms of the hospital. The medical reform strategies in this article, in fact, are as to realize promoting the hospital's implementation of medical reform through completing the infrastructures, optimizing the allocation of specialist departments, raising the overall quality of service, introducing the medical talents, constructing an information system and other developing strategies. In fact, the medical reform strategies of the people's hospital of Xinjin are practical significance and reference value.
本文主要采用了案例分析的方法,对新津县人民医院进行了深入地研究,并参考了设计学派基本模型,使用PEST分析法从政策、经济、文化等几个方面介绍了新津县人民医院的医疗卫生环境；然后在医院现状的基础上分析了医院内部的优势、劣势、机会和挑战；再通过确立医院的医改原则和使命,明确医院的战略发展方向,提出适宜医院发展的医改具体实施措施,特别是在医院新的发展理念和精细化管理模式上更是做了很多的努力；最后对医院医改战略实施后的一些阶段性成果做了简单地介绍和说明。本文所提的医改战略,实质上是希望新津县人民医院通过实施基础设施完善、专科科室优化配置、全面服务质量提升、满意度管理、人才引进、信息化建设、文化建设等各项发展性战略来推动医院医改的实现。事实证明,新津县人民医院在实施这些战略后,确实得到了很大地发展,因此,本文的研究总结具有一定的实践意义和参考价值。
With the medical reform strategies proposed, people are highly anticipated to the major livelihood project whose goal is "Everyone will have access to basic medical and health services". As a core part of the project, the development of country hospitals is attracting everyone's attention. The people's hospital of Xinjin was founded in1942, more than70years of developing history, is the only one large-scale comprehensive country hospital in Xinjin. Under the call of medical reform, the government stepped up efforts to support country hospitals, which made the development of country hospitals have a new strong driving force. And the people's hospital of Xinjin actively implements each development strategies to overcome its predicament, realizing a profit. With the improvement of medical service level, the development of the hospital has been promoted.
This article takes the people's hospital of Xinjin as an example to have a deep research, and uses the basic model of the design school as a reference. First it introduces the external factors such as politics, economy and culture. Then based on the current situation, it analyzes the internal situation such as strengths, weaknesses, opportunities and threats. Next it indicates the direction of the hospital and the specific medical reform strategies through putting forward medical reform principles and the hospital's mission. Finally, it introduces and explains the stage results after implementing the medical reforms of the hospital. The medical reform strategies in this article, in fact, are as to realize promoting the hospital's implementation of medical reform through completing the infrastructures, optimizing the allocation of specialist departments, raising the overall quality of service, introducing the medical talents, constructing an information system and other developing strategies. In fact, the medical reform strategies of the people's hospital of Xinjin are practical significance and reference value.
引文
[1]贝瑞,赛尔曼.向世界最好的医院学管理[M].机械工业出版社,2009
[2]董恒进.对公立医院改革发展趋势的探讨[J].中华医院管理杂志,2012(1)
[3]菲利普·朗曼.最好的医疗模式——公立医院改革的美国版解决方案[M].北京大学出版社,2011
[4]龚健毅,李建华.新医改与医院营销[M].上海科学技术出版社,2010
[5]胡凤霞.基层医院管理[J].中国管理信息化,2011,14(16)：68-69
[6]胡立.营销战略与竞争定位[M].中国人民大学出版社,2007
[7]亨利·明茨伯格.战略历程—纵览战略管理学派[M].刘瑞红.机械工业出版社,2002：17-32
[8]李林,刘国恩.我国盈利性医院发展与医疗费用研究：基于省级数据的实证分析[J].管理世界,2008(10)：54-62
[9]刘乐斌,陈俊国,李瑛.中外医院医疗成本控制模式探析[J].中国医院管理,2011,31(5)：67-68
[10]刘艳秋.医院营销战略研究[J].医院管理管理论坛,2011,28(9)
[11]梁文雄.论基层医院管理决策中审时度势与科学决策[J].咨询与决策,2002(7)
[12]濑户山元一.以患者为中心的医院[M].北京大学医学出版社,2009
[13]马昊芸.医院文化塑造医院核心竞争力[J].卫生软科学,2011,25(8)525-526
[14]美国、中国、日本GDP排名和预测[OL]:http://www.8pu.com/
[15]聂吉吉.医院门诊流程重组与医院信息化[J].中国数字医学,2008,8(2)：34-35
[16]裴富荣.浅析医院信息化管理[J].中医药管理杂志,2011,19(6)：588-589
[17]阮丽琴.医院文化建设探讨[J].决策与信息,2011(3)：193
[18]沈竹均,宋培琳,朱海涛.如何在医院管理中发展建设性冲突[J].中国医学伦理学,2012(4)：469-471
[19]瓦拉瑞尔A.泽丝曼尔,玛丽·乔·比特纳.服务营销[M].第四版.张金成.机械工业出版社,2008
[20]吴光哲,王宏伟,马晓军.心理咨询在医院管理中的作用[J].解放军医院管理杂志,2012(5)：475-476
[21]吴群红.基于顾客价值导向的医院营销理论与实践[M].人民卫生出版社,2012
[22]吴传俭.公平与卓越：英国卡梅伦政府医改之路[M].科学出版社,2013
[23]王宇.医院经营管理中的成本控制[J].中国管理信息化,2011,14(17)
[24]夏文婷.论医院成本管理及其必要性[J].中国外资,2011(18)
[25]余健儿,张英.现代医院营销战略[M].广东人民出版社,2002
[26]杨静.基层医院不合理应用抗生素现象分析及管理对策[J].医学信息,2011,24(1)
[27]朱丽丽.公立医院改革中的舆论引导问题探讨[J].中华医院管理杂志,2013(2)：154-156
[28]周萍,常继乐,黄金星.我国公立综合性医院战略定位类型研究[J].中国医院管理,2011,31(6)：8-9
[29]周斌,王振维.某二级医院门诊业务流程重组实践及思考[J].重庆医学,2008,37(24)
[30]赵一俏.深化运行机制改革以促进医院发展[J].中华医院管理杂志,2012(2)：91-93
[31]赵宁志,刘文华,高茗.市场营销战略与医院管理[J].解放军医院管理杂志,2008(1)：67-68
[32]赵跃华.数字化医院建设中业务流程重组的实施[J].中华医院管理杂志,2008,24(4)：245-247
[33]赵棣.困境与未来.中国公立医院的改革之路[M].科学出版社,2011
[34]张翠华.基于医生处方行为的影响因素及约束机制分析[J].中国社会医学杂志,2011,28(4)：246-248
[35]Adham, Davoud, Delghoshaei, Bahram. Team Effectiveness in Hospital Management:A Literature Review[J]. HealthMed,2012,6(6):2169-2175
[36]Catherine. Challenging Operations:Medical Reform and Resistance in Surgery[J]. Sociology of Health and Illness,2012,34(8)
[37]Celine Chew. Positioning and Its Strategic Relevance[J]. Public Management Review, 2006,8(2):334-343
[38]Dana L. Alden, Jan-Benedict E.M. Steenkamp. Brand Positioning through Advertising in Asia, North America, and Europe:The Role of Global Consumer Culture [J]. Journal of Marketing,1999,63:75-87
[39]Elaine M. Silverman. The Association Between for Profit Hospital Ownership and Increased Medicare Spending[J]. The New England Journal of Medicine,1999
[40]John Martin. Problem Analysis:Application in the Development of Market Strategies for Health Care Organizations[J]. Journal of Health Care Marketing,1988,8(1):5-16
[41]John R. Hauser. Competitive Price and Positioning Strategies [J]. Marketing Science, 1988,7(1):76-90
[42]Joel W. Hay, PhD. Hospital Cost Drivers:An Evaluation of 1998-2001 State-Level Data[J]. The American Journal of Managed Care,2003,9(13-24)
[43]Kenneth W. Clarkson. Some Implications of Property Rights in Hospital Management[J]. Journal of Law and Economic,1972,15(2):363-365
[44]Lodhi A, Khan SA, Ahmed E. Pre-hospital Management of Spinal Injuries in a Natural Disaster[J]. J Ayub Med Coll Abbottabad,2011,23(4):10-12
[45]Marcin Kesy. Competence of Doctors in Hospital Management J]. Ad Alta:Journal of Interdisciplinary Research,2012,2(2):47-51
[46]Melanie James. A Provisional Conceptual Framework for Intentional Positioning in Public Relations[J]. Journal of Public Relations Research,2011,23(1):93-118
[47]Mita Sujan, James R. Bettman. The Effects of Brand Positoning Strategies on Consumers' Brand and Category Perceptions:Some Insights From Schema Research[J]. Journal of Marketing Research,1989:454-467
[48]Serdar Sayman, Stephen J. Hoch, Jagmohan S. Raju. Positioning of Store Brands[J]. Marketing Science,2002,21(4)
[49]Sctt Reeves and Simon Lewin. Interprofessional Collaboration in the Hospital: Strategies and Meanings[J]. Journal of Health Services Research & Policy,2004
[50]Wenyu Dou. Brand Positioning Strategy Using Search Enging Marketing[J]. MIS Quarterly,2010,34(2)
[51]Yiping Chen, Lixin Jiang, Qiuli Zhang. Doctor-reported hospital management of acute coronary syndrome in China:A Nationwide Survey of 1029 Hospitals in 30 Provinces[J]. World Journal of Cardiovascular Diseases,2012,2(3):168-176
[52]Magalhaes, Maria da Consolacao. Severe Acute Maternal Morbidity:use of the Brazilian Hospital Information System[J]. Revista de Saude Publica,2012,46
[53]Rauscher Singh, Simone, Wheeler. Hospital Financial Management:What Is the Link Between Revenue Cycle Management, Profitability, and Not-for-Profit Hospitals' Ability to Grow Equity?[J]. Journal of Healthcare Management,2012,57(5)
[54]Ginn, Gregory O. Hospital Financial Position and the Adoption of Electronic Health Records [J]. Journal of Healthcare Management,2011,56(5)
[2]董恒进.对公立医院改革发展趋势的探讨[J].中华医院管理杂志,2012(1)
[3]菲利普·朗曼.最好的医疗模式——公立医院改革的美国版解决方案[M].北京大学出版社,2011
[4]龚健毅,李建华.新医改与医院营销[M].上海科学技术出版社,2010
[5]胡凤霞.基层医院管理[J].中国管理信息化,2011,14(16)：68-69
[6]胡立.营销战略与竞争定位[M].中国人民大学出版社,2007
[7]亨利·明茨伯格.战略历程—纵览战略管理学派[M].刘瑞红.机械工业出版社,2002：17-32
[8]李林,刘国恩.我国盈利性医院发展与医疗费用研究：基于省级数据的实证分析[J].管理世界,2008(10)：54-62
[9]刘乐斌,陈俊国,李瑛.中外医院医疗成本控制模式探析[J].中国医院管理,2011,31(5)：67-68
[10]刘艳秋.医院营销战略研究[J].医院管理管理论坛,2011,28(9)
[11]梁文雄.论基层医院管理决策中审时度势与科学决策[J].咨询与决策,2002(7)
[12]濑户山元一.以患者为中心的医院[M].北京大学医学出版社,2009
[13]马昊芸.医院文化塑造医院核心竞争力[J].卫生软科学,2011,25(8)525-526
[14]美国、中国、日本GDP排名和预测[OL]:http://www.8pu.com/
[15]聂吉吉.医院门诊流程重组与医院信息化[J].中国数字医学,2008,8(2)：34-35
[16]裴富荣.浅析医院信息化管理[J].中医药管理杂志,2011,19(6)：588-589
[17]阮丽琴.医院文化建设探讨[J].决策与信息,2011(3)：193
[18]沈竹均,宋培琳,朱海涛.如何在医院管理中发展建设性冲突[J].中国医学伦理学,2012(4)：469-471
[19]瓦拉瑞尔A.泽丝曼尔,玛丽·乔·比特纳.服务营销[M].第四版.张金成.机械工业出版社,2008
[20]吴光哲,王宏伟,马晓军.心理咨询在医院管理中的作用[J].解放军医院管理杂志,2012(5)：475-476
[21]吴群红.基于顾客价值导向的医院营销理论与实践[M].人民卫生出版社,2012
[22]吴传俭.公平与卓越：英国卡梅伦政府医改之路[M].科学出版社,2013
[23]王宇.医院经营管理中的成本控制[J].中国管理信息化,2011,14(17)
[24]夏文婷.论医院成本管理及其必要性[J].中国外资,2011(18)
[25]余健儿,张英.现代医院营销战略[M].广东人民出版社,2002
[26]杨静.基层医院不合理应用抗生素现象分析及管理对策[J].医学信息,2011,24(1)
[27]朱丽丽.公立医院改革中的舆论引导问题探讨[J].中华医院管理杂志,2013(2)：154-156
[28]周萍,常继乐,黄金星.我国公立综合性医院战略定位类型研究[J].中国医院管理,2011,31(6)：8-9
[29]周斌,王振维.某二级医院门诊业务流程重组实践及思考[J].重庆医学,2008,37(24)
[30]赵一俏.深化运行机制改革以促进医院发展[J].中华医院管理杂志,2012(2)：91-93
[31]赵宁志,刘文华,高茗.市场营销战略与医院管理[J].解放军医院管理杂志,2008(1)：67-68
[32]赵跃华.数字化医院建设中业务流程重组的实施[J].中华医院管理杂志,2008,24(4)：245-247
[33]赵棣.困境与未来.中国公立医院的改革之路[M].科学出版社,2011
[34]张翠华.基于医生处方行为的影响因素及约束机制分析[J].中国社会医学杂志,2011,28(4)：246-248
[35]Adham, Davoud, Delghoshaei, Bahram. Team Effectiveness in Hospital Management:A Literature Review[J]. HealthMed,2012,6(6):2169-2175
[36]Catherine. Challenging Operations:Medical Reform and Resistance in Surgery[J]. Sociology of Health and Illness,2012,34(8)
[37]Celine Chew. Positioning and Its Strategic Relevance[J]. Public Management Review, 2006,8(2):334-343
[38]Dana L. Alden, Jan-Benedict E.M. Steenkamp. Brand Positioning through Advertising in Asia, North America, and Europe:The Role of Global Consumer Culture [J]. Journal of Marketing,1999,63:75-87
[39]Elaine M. Silverman. The Association Between for Profit Hospital Ownership and Increased Medicare Spending[J]. The New England Journal of Medicine,1999
[40]John Martin. Problem Analysis:Application in the Development of Market Strategies for Health Care Organizations[J]. Journal of Health Care Marketing,1988,8(1):5-16
[41]John R. Hauser. Competitive Price and Positioning Strategies [J]. Marketing Science, 1988,7(1):76-90
[42]Joel W. Hay, PhD. Hospital Cost Drivers:An Evaluation of 1998-2001 State-Level Data[J]. The American Journal of Managed Care,2003,9(13-24)
[43]Kenneth W. Clarkson. Some Implications of Property Rights in Hospital Management[J]. Journal of Law and Economic,1972,15(2):363-365
[44]Lodhi A, Khan SA, Ahmed E. Pre-hospital Management of Spinal Injuries in a Natural Disaster[J]. J Ayub Med Coll Abbottabad,2011,23(4):10-12
[45]Marcin Kesy. Competence of Doctors in Hospital Management J]. Ad Alta:Journal of Interdisciplinary Research,2012,2(2):47-51
[46]Melanie James. A Provisional Conceptual Framework for Intentional Positioning in Public Relations[J]. Journal of Public Relations Research,2011,23(1):93-118
[47]Mita Sujan, James R. Bettman. The Effects of Brand Positoning Strategies on Consumers' Brand and Category Perceptions:Some Insights From Schema Research[J]. Journal of Marketing Research,1989:454-467
[48]Serdar Sayman, Stephen J. Hoch, Jagmohan S. Raju. Positioning of Store Brands[J]. Marketing Science,2002,21(4)
[49]Sctt Reeves and Simon Lewin. Interprofessional Collaboration in the Hospital: Strategies and Meanings[J]. Journal of Health Services Research & Policy,2004
[50]Wenyu Dou. Brand Positioning Strategy Using Search Enging Marketing[J]. MIS Quarterly,2010,34(2)
[51]Yiping Chen, Lixin Jiang, Qiuli Zhang. Doctor-reported hospital management of acute coronary syndrome in China:A Nationwide Survey of 1029 Hospitals in 30 Provinces[J]. World Journal of Cardiovascular Diseases,2012,2(3):168-176
[52]Magalhaes, Maria da Consolacao. Severe Acute Maternal Morbidity:use of the Brazilian Hospital Information System[J]. Revista de Saude Publica,2012,46
[53]Rauscher Singh, Simone, Wheeler. Hospital Financial Management:What Is the Link Between Revenue Cycle Management, Profitability, and Not-for-Profit Hospitals' Ability to Grow Equity?[J]. Journal of Healthcare Management,2012,57(5)
[54]Ginn, Gregory O. Hospital Financial Position and the Adoption of Electronic Health Records [J]. Journal of Healthcare Management,2011,56(5)
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