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The Mode and Perfecting Path of Division between Regulation and Management Affaires of China’s Medical Service

Author: WeiXiaoZuo
Tutor: GuoJianMing
School: Zhejiang University of Finance
Course: Administration
Keywords: medical service division between regulation and management affaires mode public hospital corporate governance structure government function
CLC: R197.1
Type: Master's thesis
Year: 2013
Downloads: 191
Quote: 0
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In the traditional system, the government as the agent of the state made use of administrative power, and served as the organizer, manager, operator, supervisor and other multiple roles of medical service. In the long-term run the drawbacks would be more obvious. Inevitably it had become a historical trend that promote division between regulation and management affaires, transform the government’s functions, optimize the supply of public services, andmeet the multi-level social needs for health service. Division between medical service regulation and management affaires was to separate ownership and management rights of public hospital moderately, of which the core was the transformation and repositioning of government functions.Generally, division between China’s medical service regulation and management affairesexhibited the trend of hospital management institutionalization, corporate and group governance of public hospital. The practice of reform fully reflected these tendencies: to establish ahospital management institutions to carry out the duties of investor and be responsible for the operation of affiliated hospitals; to realize cooperate governance structure, entrust the hospital committee or the council with the hospital decision-making authority and implement the responsibility of the president; to build medical groups through joint, trust, restructuring, andcarry on medical cooperation with local hospitals.According to the nature and organized way, it was divided into three modes: Beijing Haidian, Shanghai Shenkang, Wuxi represented the mode of "division between government regulation and management affaires "; Suzhou represented "government regulating, society managing" mode; major hospitals and hospital groups represented “government regulating, unit managing "mode.Though three modes had the organizer of different properties, management functions ofthe different range and governance framework of different components, they had similar external structural elements and internal operating mechanism, which included corporate governance structure of the council, personnel system for customer satisfaction and healthcare financing system of various capitals and so on.According to the results of comparison, it was found that the reform did help improvethe operating efficiency of the health service, but quality and safety indicators didn’t improv e, thus affected the progress of the overall performance of the resources allocation. There were still some defects and problems in the modes of “division between regulation and management affaires”, which had impeded the normal operation of the mechanism.Hence, we need use the experience of division between medical health service regulation and management affaires of the United Kingdom, Hong Kong, United States, Singapore and other countries or regions in advanced mode, system of organization, management structure,financing system, supervision mechanism in order to provide important reference for Chinato deepen the reform of public institutions and administration structure reform. On the basisof the normative functions and clear nature of the existing main body, we must develop a clear reform direction, define explicit duties of the main body, and encourage social forces toparticipate in the supply of medical services; make efforts to promote the reform of the internal management system of medical institutions, form vibrant and efficient management andoperation mechanism, establish a new corporate governance structure, competitive personnelmanagement system, effective incentive and restraint system, broaden health financing channels, increase financial input; establish a standard supervision mechanism of state-owned assets,clear the legal status of the hospital management institutions.The mode of division between medical service regulation and management affaires wasessentially a result of the introduction of market mechanisms in the governance process. How to take full advantage of the power of the invisible hand, rationally allocate and utilize health resources, optimize the combination of market and planning, and ultimately achieve policy objectives, was the direction of government reform.

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CLC: > Medicine, health > Preventive Medicine,Health > Health care organizations and career ( Health Management ) > Health care systems and institutions > Health care system
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