Research On Public Hospital Groups Economics Analysis And Government Structure

Chinese health resources allocation efficiency and fairness remains low, and the problem of "investment deficiency and waste coexisting" exists in health service for quite a long time. There in the health service industry are vertical divisions, repetitive construction, disorderly competitions, and malignant competitions. The large amount of medical investment cannot have the corresponding social and economical effect; on the contrary, "difficult and expensive to see a doctor" is becoming more and more to serious. In order to accelerate the progress of reform from the planned economy system to the market economy system and enhance competitive ability of the hospitals, from the later period of 1990s, Chinese government has successively established "Health Service Reform and Development Decision of the Central Committee of the CCP and the State Council ", "Instructions on City Health Organizational reform " and so on to advance the regional health resources reorganization and the medical establishment reforms. At that time, the rudiment of hospital groups formed by the intervention of government. But because of problems in hospital management and policy environment, a series of questions, such as diseconomy scale, "following phenomenon", property right appeared in the collectivization of hospital groups.This research comes from the army "the 10th 5 year" health scientific research project (number: 06L024). Based on above background, this research takes the hospital group as the object, though the analysis of development pattern and the government structure, policy environment, system regulation with the methods of game theory, econometrics modeling, agent cost analysis and property right theory, to put forward opinions and the suggestion on the public hospital groups' management system and the government structure, which will do great help to scientific organization, steady development, and coordinated management of hospital groups, health organization reform and macro health policy-making.This research is composed by four parts: first, research on the form and development of Chinese public hospital groups; second, economic analysis on the public hospital groups; third, feasibility analysis and government structure of the public hospital groups; fourth, interior government of public hospital groups. Main findings are listed as follows:Analysis on the main problems of public hospital groups discussed the characters, questions and reform of macro management system and microcosmic management mechanism of public hospital group. It reveals that in the public ownership system and under the planned economy system, canceling the independent management right of public hospitals is conform to the economical logical choice, and the most effective regulation arrangement under current conditions. Use supply and demand analysis and the price control investment decision-making model to discuss the limitation of profit reform. Use the Coumot countermeasure model to prove that in incompletely competition condition, if the public hospital group management cannot remarkably reduce the cost, patients' welfare would be harmful. Therefore, the key to hospital group management lies in consummation of the hospital groups' government structure. Stakeholders and headquarters of the public hospitals must do their best to effectively monitor and inspire underling hospitals to diligently reduces the cost in the public hospital management goal scope and enhances the efficiency.The public hospital groups' feasibility analysis and the group government structure analysis introduced the basic content of modem company government theory, and thought the hospital group exterior government was most basic, and at the same time the most important constituent of the group management. By the means of Fisher separation theorem under complete capital market, it proved the importance of the organization existence and strict implementation, on which we proposed the best government structure of public hospital groups. And through the hospital group prestige model, it further explained the public hospital execution group management is the effective method to remold the public hospital property right, and to solute property right problem.The consummation of public hospital group's internal government and inspiration mechanism research explained the common rules of the public hospital group headquarters, and proved the profit-target sharecropping drive method was not suitably to use in present medical service, which was generally adopted. Interact model among the hospital group interior hospitals proved the problem of induced competition; referring to rules and regulations against monopolistic company in the market economy nations, we put forward two kinds of quite feasible thoughts of mechanism design mentality for hospitals operators and the model proof.