The Government Regulation Pattern Research Based On Incentive System For The Public Hospital

ObjectivesIn order to develop social resources effectively, improve the efficiency of the public funds, maintain the fair competition, ensure the quality of the health service and maintain the rights and interests of patients, the functioning and efficient regulatory system had to be established. And the health care services of public hospitals were so complex. It was difficult to establish the regulatory system.In this study, the theory of incentive regulation in the new regulation economics was used to analysis the key sectors and factors of public hospitals regulation. Based on a comprehensive understanding of the regulatory status quo of China's public hospitals, the incentive contract model (Holmstrom and Milgrom incentive contract model) was used to constraint between the government and the public hospitals.MethodsLiterature method:In this study, quantitative and semi-quantitative analysis was used to collect and analyze the public hospital regulation literature.The theoretical model:In this study, the theory of incentive regulation in the new regulation economics was used to analysis the key sectors and factors of public hospitals regulation. Based on a comprehensive understanding of the regulatory status quo of China's public hospitals, the incentive contract model (Holmstrom and Milgrom incentive contract model) was used to constraint between the government and the public hospitals.Investigation:In this study, an investigation was done in Hubei province and Guangdong province. The medical staff and patients were investigated. In total, there were 161 medical personnel and 299 patients were investigated.Interviews:In this study, the heads of Finance, Price and Health were interviewed. Also the managers in the public hospitals were interviewed.Data analysis:In this study, the mean, the standard deviation-square test and logistic regression analysis were used.Results1 The situation of public hospital incentive regulationIn the process of government regulation of public hospitals, the government should adopt a series of incentives in order to improve the efficiency of regulation. The incentive regulation process was actually a well-designed and implemented to meet both the government and the public hospitals.2 The evolution of regulatory policy of public hospitalsPublis hospital regulatory of policy was divided into four stages. They were government strict regulatory system stage (before 1983), the government relaxed regulation period (1984-1992), the government further relaxed regulatory period (1993-1998) and the reform of regulation period (December 1998 to present).3 Analysis of China's public hospitals, government regulation 3 The status of government regulation about public hospitals3.1 The incentive incompatibility of government regulation about public hospitalsThere were some incentive incompatibility problems:First, the cost of administrative regulatory was too high. Second, the excessive regulation and the prudential regulation. Finally, the regulatory philosophy was out.3.2 The difficulties about the government regulationIn this study, the theory of incentive regulation in the new regulation economics was used to analysis the key sectors and factors of public hospitals regulation. Based on a comprehensive understanding of the regulatory status quo of China's public hospitals, the incentive contract model (Holmstrom and Milgrom incentive contract model) was used to constraint between the government and the public hospitals.4 The key factors of government regulation4.1 The goals of government regulationPublic hospital regulation overall objective was to maximize the welfare of society as a whole. The goals of government regulation were stability, fairness, efficiency and development.4.2 The key factors of government regulationObtained through expert consultation, the government has put in the relevant policies and institutions, various government departments with the extent of impact compared with other important; public hospital were willing to accept the wishes of the regulation, the division of functions between departments was reasonable.5 The design of government regulatory contract model To increase the revenue of public hospitals, deal with hospital operators to establish suitable incentives linked to the operator's revenue and revenue of public hospitals and could be appropriate to reduce the proportion of fixed income, and increase the proportion of performance pay.6 Government incentive regulation mechanism of the implementation stragyRegulation strategy include the set of independent regulatory agencies, and regulators to provide incentives for effective regulation; the regulator's strategy includes building a corporate governance model, the establishment of the hospital manager market-president of professional and public hospitals obey regulatory incentives in three aspects.Conclusions1 Government in public hospitals, the incentive regulation process was actually a well-designed and implemented to meet both the government and the public hospitals the incentive compatibility of the contract.2 The public hospitals in government regulation reform period.3 The public hospitals, the incentive incompatibility problem is mainly an administrative regulatory costs were too high, excessive regulation and inadequate prudential regulation, lack of effective oversight of the regulators and regulatory philosophy behind.4 Government behavior is mainly affected by the political incentives and constraints-performance evaluation mechanisms and financial incentives and constraints-the impact of fiscal decentralization, resulting in a lack of government regulatory power of public hospitals and public hospitals, lack of government regulation.5 The goal of government regulation of our public hospitals, including the goal of stability, fairness objectives, efficiency targets and development goals.6 Government spending, policies and systems, the degree of cooperation between various government departments are the key factors affect the public hospitals, government regulatory effect.7 Hospital operators to establish appropriate incentives can be appropriate to reduce the proportion of fixed income, increase the proportion of performance pay.8 Managers in the design of incentive mechanism to ensure the long-term incentives to improve the enthusiasm of the operators of public hospitals.9 Management capacity of managers to determine their influence on hospital profitability was an important factor.10 Asked the regulator's strategy includes a set of independent regulatory agencies, and regulators to provide incentives for effective supervision; regulatory aspects of strategy includes building corporate governance model, the establishment of the hospital manager market-president of professional and public hospitals (operators) obey regulatory incentives in three aspects; the realization of conditions of supervision, including the rule of law based on perfect information disclosure system, and build industry self-regulatory mechanism.Innovations and meritsIn this study, based on a comprehensive understanding of our public hospitals, government regulatory status quo, the use of a multidisciplinary approach to our public hospitals, government regulatory system, from the perspective of hospital regulatory mechanism innovation, the use of mechanism design theory and methods (Holmstum and Mligrom model) to study the principal-agent relationship with the incentives in the public hospitals.