Study On Hospital Governance Models: A Perspective Of Three-dimension

Most research on hospital governance models mainly focus on constructing and improving the legal person governance structure of hospital from a microcosmic perspective. Major points follow theories of corporate governance models on the whole. But few studies explore the three-dimension characteristic affecting on hospital governance models. This paper tries to demonstrate that structure dimension, connection dimension, and performance dimension are decisive factors influencing the selection of hospital governance models and its operating efficiency. Only when the governance modal of a hospital fits with its three-dimension characteristic enable it to improve efficiency on a solid base. Thus, this paper constructs a three-dimension structure consisting of structure dimension, connection dimension, and performance dimension to analyze and explore the selection of hospital governance models.In recent years, hospitals start the adjustment of ownership structure and governance structure in our country. As the extension of state-owned enterprises reform, its steps almost follow the reform of state-owned enterprises. Most research on hospital governance models mainly focus on corporation system. Because of the particularity of health service and important influence upon steady society, the reform failed that nonprofit hospital transforming profit Hospital, corporate governance model of hospital. Because of the difference in specific of medical product, asymmetric knowledge between doctor and patient resulting in induced demand, hospital governance models, especially nonprofit hospital governance models, are different to corporate governance models. The principle of corporate governance cannot be applies to hospital directly. Now, hospital governance models don't suit to the nature of health service and hospital. Hospital governance models cannot make governance mechanism working in coordination, solve the problem that select and control the operator of hospital, bring into line utilize contradictions of stake holder in hospital. On the other hand, the system of hospital governance is imperfect. So hospital governance is inefficiency. This paper tries to explore the transform of hospital governance models based on structure dimension, connection dimension, and performance dimension. Structure dimension consist of financial structure and administrative levels. Connection dimension consist of environment, the aim of hospital, the scale of hospital, the skill and culture of hospital. Performance dimension consist of the realization of aim, the ability of obtain resources, controls of process and the satisfied degree of stake holder. These factors have a great influence upon the framework of hospital. The three-dimension structure can point out the transform path and trend of hospital governance models in the future, and put forward the new idea to the difficult position of hospital governance. That is, any hospital governance models are relatively effective. There isn't a best of governance models. Hospital governance models must fit in with the structure dimension, the connection dimension, and the performance dimension of hospital. By improving the operation conditions of different governance mechanism that rooted from the in-depth analysis and recognition of hospital and health care in our country, the ultimate goal of hospital and health care reform could be achieved at lowest cost.The dissertation is divided into 8 chapters. It begins with the introduction of the background of this paper, the value of the subject, research approaches, structure and innovational ideas. Chapter Seven is the Conclusion and Research Prospect part. It concludes with the suggestion that the variety and individual trend of hospital governance models is an ideal choice in China. It also points out the imperfections in anglicizing hospital governance from three-dimension and suggests potential research directions in the future. The other six chapters can be divided into three parts, theoretical analysis, empirical analysis, and strategy and trend research.Theoretical analysis includes Chapter One, Chapter Two and Chapter Three. Chapter One is Review of Governance Theory. It introduces basic theories and main standpoints in corporate governance, public organization governance and nonprofit organization research fields. It points out the theoretical structure of governance. Chapter Two is Nature of Hospital and Its Governance. It study and analysis the influence each other between nature of hospital change and hospital governance models transform. On the basis of concluding medical market theories, it points out that a more extensive frame of hospital governance analysis must be established. Chapter Three is Analyzing Frame of Hospital Governance. It emphasize that a three-dimension analysis frame is necessary to establish hospital governance models. The three-dimension consist of structure dimension, connection dimension, and performance dimension.Empirical part includes Chapter Four and Chapter Five. Chapter Four Analysis of Typical Hospital Governance Models, A Perspective of Three-dimension. Based upon the introduction to history and mainly models of hospital governance, the analysis and the comparison of mainly hospital governance, it points out that the selection of hospital governance models is tactical and effective. Chapter Five is The Empirical Analysis of The Current Governance Situations in China's Hospital. Based upon the introduction to the transformation of China's hospital governance and its three-dimension characteristic, this Chapter describes and analyzes a case through Three-dimension frame. It indicates that structure dimension, connection dimension, and performance dimension pool efforts to improving hospital governance. The result shows that the essential reason for hospital governance models fails to function well is because it does not cope with the three-dimension frame.Strategy and trend research is Chapter Six, Selection of Governing Models for China's Hospital. It elaborates the power of structure elements, the guidance of connection variables, the action of performance goals and the mainly transform path in the future. It points out the probable change orientation and diversified selection of hospital governance models. It also gives some pragmatic suggestions on how to improve China's hospital governance models.Innovational ideas of this paper are as follows:1. From organization structure of hospital perspective, it examines the interactive relation between organization structure and hospital governance, analysis the mechanism of three-dimension in organization structure. It also points out that hospital governance models is the aggregation of three dimensions. Because of the power of structure elements, the guidance of connection variables, the action of performance goals and the mainly transform path in the future, the hospital governance models assume diversified aspect. The proposed studying begins from structure dimension, connection dimension and performance dimension provides a new research framework for improving the hospital governance models in our country.2. Now, the study on hospital governance model ignores the special public function of hospital. Because the goal of hospital is different from corporation, government and nonprofit organization, hospital governance models is most peculiar.3. Based upon three-dimension frame, this paper concludes and analysis some kinds of representative hospital governance models in the West and its nature, especially nonprofit hospital governance models. These hospital governance models are tactical and effective.4. Nonprofit Hospital's Performance isn't only influenced by the nature of hospital but also by hospital governance models. Choosing Evaluation Dimensions is very important to the selection of hospital governance. Developing Performance Evaluation Dimensions from controls of process, service efficiency to suitability, equitableness, financial condition and so on can analyze the defect of hospital governance and gives new ideas.5. There are three natures of hospital governance models change. First, the system is the main guidance of connection variables. Second, the realization of profit goal is the main action of performance goals. Third, the sign of structure elements power is that the administrative right redistributed.6. Because of national conditions and natures of health reform, Hospital governance models of controlling Government should still be the principal model in the long-run. But it doesn't means that there is only one model of hospital governance in our country. In future, the change in structure dimension, connection dimension, and performance dimension can make hospital governance models diversified.