A Research Of Public-private Cooperation In Clinical Laboratories Of Public Hospitals And Government Guidance Strategies

Under the current medical and health system,the source of funds in the field of medical and health in China mainly depends on government investment.The traditional mode of medical service supply has been difficult to meet the growing health needs of the public.Due to the lack of government investment for a long time,the total amount of medical and health resources in China is limited,the allocation efficiency is not high,and the contradiction between supply and demand of medical and health services is prominent.As a relatively mature financing tool,public-private partnership(PPP)can not only broaden the financing channels for public hospitals,but also improve the quality and efficiency of medical service supply with the help of advanced management experience of social capital.With the deepening of health care reform,there are many cases of public-private partnership in domestic public hospitals,but there are also many problems in the process of practice,such as lack of high-level laws and regulations to support,imperfect regulatory system,deficiencies in cooperation mechanism and so on,which lead to the public interests difficult to be guaranteed.For example,the "pharmacy trusteeship" in public hospitals,one of the PPP applications in the field of medical and health care,has been formally suspended by the government because of a series of problems exposed in its operation,such as failing to realize the separation of pharmaceuticals,lowering drug prices,affecting drug safety and harming public interests.Like pharmacies,clinical laboratories of hospitals,which are also the auxiliary departments of diagnosis and treatment,operate more depending on the support of testing equipment and reagent consumables,and require higher cost control.With the implementation of zero price difference policy for drugs and consumables,the pressure of cost and fee control is increasing.In recent years,many clinical laboratories in public hospitals have begun to introduce social capital to cooperate in various modes,referring to the "pharmacy trusteeship" model.As a new thing under the background of the new medical reform,such cooperation projects inevitably have various problems in practice.In order to prevent risks,give full play to the role of public-private partnership model and protect public interests,this paper studies the mechanism and existing problems of this kind of public-private partnership model,and puts forward corresponding countermeasures and suggestions.This paper adopts the method of literature research.First,it collects and collates the relevant literature over the years and analyses the research results of scholars at home and abroad as a reference.Then,through the case study of Guangzhou A District Maternal and Child Health Hospital,which has been carrying out the public-private cooperation project of clinical laboratory,through in-depth interviews,we have communicated and exchanged with many relevant health administrators,hospital managers,social capital investors,clinical laboratory staff and staff of trade associations in many aspects,and have a deep understanding of such projects.The actual operation status and existing problems accumulate abundant data and data for this study.Based on the collected data and field investigation,it is found that the prospects of public-private cooperation in clinical laboratories of public hospitals are broad,which can alleviate the financial shortage of the government and improve the ability of hospital testing services.However,in practice,there are also some problems,such as unclear concepts of participants,inconsistency between some cooperation modes and current management policies,and the process of selecting partners.Norms,social capital participants to obtain returns to do harm to public interests and other issues.The main reasons are that the concept of public-private partnership governance is backward,lack of top-level PPP legal system support,unclear regulatory body,unreasonable risk and income distribution mechanism,imperfect performance appraisal system and so on.Based on the successful experience of foreign countries and the experience and lessons learned from the practice of "pharmacy trusteeship",this paper puts forward the countermeasures and suggestions for improving PPP project in clinical laboratories of public hospitals in China.Firstly,we should establish a multi-governance model of public-private cooperation in the field of medical and health services to meet the governance requirements of the current multi-production-multi-supply pattern of medical and health services,including speeding up the improvement of the field of public-private cooperation.The legal system,the establishment of specialized management institutions involving multiple subjects,the establishment and improvement of risk and income management mechanism,the establishment of a scientific and reasonable performance appraisal system and the establishment of information disclosure mechanism.Secondly,aiming at the key points of such projects,practical suggestions are given from three aspects: choosing the appropriate cooperation mode,standardizing the selection method of partners and standardizing the content of project contracts.