基于利益链的公立医院社会责任研究
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摘要
医疗卫生事业是“民生”或社会保障领域的重要一环。医疗服务的公平性与可及性是一个国家医疗卫生事业发展水平的主要标志。而政府投资的公立医院正是世界大多数国家包括中国医疗服务的主要提供者。公立医院的“公立”二字决定了其公益性特点，但这并不是它存在的全部理由。通过对公立医院本质和社会责任的研究以及对医院利益和价值创造规律、利益保护与影响因素的探讨，从而建立一套完整的基于利益链的公立医院社会责任理论体系，能够激励公立医院的利益相关者投入更多资源、创造更多价值，让国家和公众得到更大利益。同时，也能够解释目前中国公立医院运营过程中所面对的障碍，以及从医疗体制弊端引出的社会问题，如：公众看病难、看病贵“问题。最终，有助于改善国家医疗卫生事业。
公立医院是社会的一份子，需要为社会尽义务，为其利益相关者如：政府出资人、患者、医务人员和社区等承担相应的社会责任。然而，有关公立医院社会责任的研究在国内尚处于初始阶段，定义和内涵不一、缺乏系统和实证研究。
本论文从最根本的问题着手，重点研究了：
第一、为什么公立医院要承担社会责任？
第二、公立医院社会责任的对象是谁？
第三、公立医院如何实现其社会责任？
第四、如何评价公立医院社会责任？
本论文在充分研究前人相关研究成果的基础上，利用经济学的理论模型与管理学的研究方法，结合对新加坡公立医院改革经验的分析，建立了一套完整的公立医院社会责任理论体系。本论文得出的主要结论和创见是：
1、建立了基于利益链的公立医院社会责任理论体系
本论文首先明确了公立医院是利益创造体的本质，该利益是以利益相关者为基础的社会利益（公益）和赖以发展的经济利益。其次，构造了由利益创造、利益分配和利益保护三个环节所组成的公立医院利益链。公立医院通过对各利益相关者的资源整合与付出，为社会创造利益和价值；完善的治理结构能够为各利益相关者合理分配这些利益，而履行社会责任则是对所有利益相关者应得利益的保护。这将使得各利益相关者有动机创造更大的利益，促进医院价值创造最大化，利益相关者利益分配合理化及最大化，从而实现社会责任。最后，本论文以严谨的递进式逻辑，建立并论证了“基于利益链的公立医院社会责任理论体系”。
2、利用科学方法确定了公立医院利益相关者
本文认为，公立医院利益相关者是公立医院社会责任的对象或受益方，也是医院治理结构的一个关键角色。医院承担社会责任就是实现各利益相关者的利益主张，也就是对利益相关者的利益保护。本文从资源依赖和资源结构理论出发，分析公立医院利益相关者的特殊性，明确了掌握知识和智慧资源的医院高级管理者与医生的核心地位，突破了政府或投资人主宰医院的传统观点。另外，将政府所有职能部门划分为“出资人”和“行业监管部门”两个利益相关者，为医院管办分离打下理论基础。在问卷调查和专家咨询的基础上，采用米切尔属性分析法确定了公立医院的四个核心利益相关者、五个预期利益相关者和两个潜在利益相关者。
3、设计出完善的公立医院利益分配即利益相关者共同治理机制
本文通过建立核心利益相关者利益博弈数学模型得出：公立医院内部核心利益相关者只有通过合作博弈才能够保证医院和自己的最大利益。同时，通过医方与患方博弈模型，确定了医方发出正确信号的重要性。在此基础上，构建了公立医院利益相关者共同治理模型，以实现利益的合理分配。该模型内部要素包括公立医院出资人制度、公立医院产权改革、有公众代表参与的董事会领导下的院长负责制结构以及医生群体的参与方式。外部要素的重点是是政府监管与补偿行为、有管制的市场行为和有导向的患者就医行为。本文也通过作者亲自调查访问得到的四个真实案例，研究政府对公立医院的合理监管方式以及公立医院改革的方向。
4、对公立医院社会责任的概念做了最新界定并设计出科学的评价指标体系
本文公立医院社会责任定义和内涵是：公立医院通过透明、守法和道德的行为，为其决策及活动给利益相关者带来之影响所承担的责任。其主要包括四个方面：效益、法律、道德和慈善责任。本文也采用科学、适宜的方法，包括专家咨询、样本调查和实际测量，以及规范的多元统计学信度和效度分析，得出完整、具操作性和指导性的基于利益相关者的三级共50个项目的公立医院社会责任评价指标体系。
5、对中国公立医院社会责任现状做了大样本调查并分析了影响因素
利用自行设计的评价指标体系，对中国公立医院社会责任现状作了大样本调查，对公立医院履行社会责任所存在的问题和原因作了深入探讨，也论证了中国公众“看病难、看病贵”问题所涉及到的医院内部原因。研究发现，中国公立医院在完成政府所规定的任务方面较为突出，但在提高医院运营效率的精细化管理、所有权与经营权分离的治理改革、医生权益保护以及医院信息透明度等方面还存在严重不足。这些问题引起相应利益相关者不满，转嫁的结果加剧了公众“看病难、看病贵”问题。
本文在理论探索和实证研究的基础上，对中国医疗体制改革提出以下对策建议：
（1）加快组建代表政府的医院出资人机构、统一政府医院出资人制度。
（2）加快制定《公立医疗机构法》，明确公立医院的法人权利、地位和责任，完善治理结构。
（3）重组公立医院现有组织制度，突出医生在医院的地位和利益。
（4）将社会责任融入公立医院核心工作和战略中。
（5）加强公民教育、改善医患关系。
（6）采取措施加大公立医院的信息透明度。
Medical care and health cause is an important link of “people’s livelihood” orsocial security field, the development level of which is remarked by thefairness and accessibility of medical service. Public hospitals invested by thegovernments are the main medical service providers in most of the world’scountries including China. The word “public” in “public hospitals”determines its public benefit characteristic but it is not the entire reason forits existence. Through the studies on the nature of public hospitals and theexploration of the value creation law of hospitals, benefit protection andinfluencing factors should be made to establish a complete set of theoreticalsystem for public hospitals’ social responsibility based on interests-chainhypothesis. In this way, stakeholders of public hospitals will be motivated toinvest more resources, create more value and make the country and the publicbenefit. Meanwhile, it can explain current obstacles facing China’s publichospitals in the operation process, and solve social problems caused byshortcomings of medial system. In the end, it is helpful to the improvementof the country’s medical care and health cause.
Public hospitals, as part of society, need to fulfill their obligations forsociety and shoulder corresponding social responsibilities for its stakeholderssuch as government investor, patients, medical staff and communities.Nevertheless, domestic study on public hospitals’ social responsibility is still at its budding stage with different opinions on its intension and extension,which still lacks of systemic and empirical studies.
This paper starts from those fundamental questions, while puts an focuson the following issues:
First, why do public hospitals need to shoulder social responsibility?
Second, who is the objective of public hospitals’ social responsibility?
Third, how do public hospitals realize their social responsibility?
Forth, how to evaluate the social responsibility?
Main research contents of the chapters are as follows:
This paper starting with the above-mentioned four questions, based onthe adequate study of previous researches in this area, takes advantages ofeconomic theory and models as well as the empirical research in managementstudies, also borrowed the successful experiences of Singapore publichospitals reform, which builds up a complete set of theoretical system onpublic hospitals’ social responsibility.
Main conclusions and innovative opinions obtained by this paper:
1. Establish a theoretical system of public hospitals’ social responsibilitybased on interests-chain.
With rigorous progressive logic, this paper has completely andcomprehensively established and proved the innovative “theoretical systemof public hospitals’ social responsibility based on interests-chain. The mainidea of the theoretical system is: public hospitals integrate and provide resources of stakeholders to create interest and value for society; improvedgovernance structure can reasonably distribute these interests for stakeholderswhile performance of social responsibility means protection of the interestwhich stakeholders deserve. This serves as a motivation for stakeholders tocreate greater interest so as to promote maximization of hospitals’ valuecreation, rationalization and maximization of stakeholders’ interestdistribution and further realize social responsibility.
2. Determine public hospitals’ stakeholders with scientific methods
This paper maintains that public hospitals’ stakeholders refer to objectsor beneficiaries of public hospitals’ social responsibility and are key roles inthe hospitals’ governance structure. Hospitals shoulder social responsibility,which means the realization of stakeholders’ interest claims and protection ofstakeholders’ interest protection. This paper starts with resource dependenceand resource structure theories, analyzes the particularity of public hospitals’stakeholders, clarifies for the first time the core position of seniormanagement teams and doctors of hospitals who possess knowledge andwisdom resources, and goes beyond the traditional view of the government orinvestors’ dominant roles in hospitals. Besides, it divides the government’sall functional departments into two stakeholders of “investors” and“regulatory departments of the industry” for the first time and pave atheoretical way for hospitals’ management offices. Based on questionnairesurvey and expert consultation, it determines public hospitals’ four corestakeholders, five expected stakeholders and two potential stakeholders withMitchell attribute analysis method.
3. Design a complete mechanism for profit distribution in publichospitals or namely the stakeholders’ co-governance mechanism.
This paper uses the game theory method to establish a mathematicalmodel of core stakeholders’ interest game, and infers that public hospitals’internal core stakeholders can only guarantee their interests by cooperativegame. At the same time, this paper infers the importance of the informationtransparence of the hospital through the game model between hospitals andpatients. Based on this inference, the paper discusses and designs a jointgovernance theory and model on the part of public hospitals’ stakeholders.Meanwhile, it studies the best choice for public hospitals’ governance frominternal and external aspects. Internal aspects include public hospitals’investor system, public hospitals’ property right reform, and presidentresponsible system structure led by the board of directors with participationof the public as well as way of doctor representatives’ participation. Externalaspects focus on government regulation and compensation behavior,regulated market behavior and oriented patient behavior of seeing doctors.This paper studies the government’s reasonable regulation of public hospitalsand the reform direction of public hospitals based on four real-life casesdrawn from the author’s personal questionnaire surveys and visits.
4. Provide a new definition of the concept of public hospitals’ socialresponsibility and design a scientific evaluation index system
This paper, based on full studies on previous scholars’ opinions, worksout the definition and connotations of public hospitals’ responsibility whichcomply with the paper’s logic, that is, through transparent, legal and moralpractice, public hospital shoulders the responsibility for the influence brought to its shareholders by its decision and practice. It mainly includes fouraspects, namely, profitability, law, morality, and benevolent responsibility.Meanwhile, it makes an explicit elaboration of four responsibilitiescorresponding to each stakeholder for the first time. This paper also adoptsscientific and appropriate methods such as expert consultation, practicalmeasurement with survey samples and standard reliability and validityanalysis of multivariate statistics to work out a complete, operable andinstructive public hospitals’ social responsibility evaluation index systembased on stakeholders. This is what the previous scholars haven’t touchedupon.
5. Conduct a large-sample survey on public hospitals’ socialresponsibility status in China and analyze influencing factors
This paper conducts a large-sample survey on public hospitals’ socialresponsibility status in China with the author’s self-designed public hospitals’social responsibility evaluation index system, and verifies the correctness ofthe theoretical system through empirical study. Besides, it goes deep into thediscussion of problems existing in public hospitals’ performance of socialresponsibility and causes as well, and provides circumstantial evidence forhospitals’ internal causes for Chinese public’s problem of “difficult access toquality medical services and expensive medical bills”. However, there’smuch left to be desired in such aspects as the delicacy management whichimproves hospitals’ operation efficiency, reform in separated governance ofownership and power of operation, protection of doctors’ rights and interestsand transparency of hospitals’ information. Corresponding stakeholders aredissatisfied with these problems so the transfer of the dissatisfaction exacerbates the problem of “difficult access to quality medical services andexpensive medical bills” for the public.
This paper proposes the following countermeasures and suggestions onChina’s health system reform, based on the theoretical exploration andempirical researches,
(1) Accelerate the establishment of hospitals’ investors organizationwhich represents the government, and standardize the government’s andhospitals’ investors system. The organization should be at the same level withlocal health department (bureau) and a statutory organization of the samenature with corporate interest’s legal representative. It exercises the power ofinvestors, is entitled to interest it deserves and meanwhile shoulderscorresponding responsibility.
(2) Speed up the formulation of “Law of Public Medical Organizations”,clarify the legal rights, position and responsibility of public hospitals,improve the governance structure and let the hospital management teamspossess full operation right with reasonable supervision. Besides,stakeholders should participate in the governance so that their rights andinterests which they deserve can be protected.
(3) Restructure current organizations of public hospitals, highlight theposition and interest of doctors in the hospital; ensure doctors can participatein the decision-making process of the hospitals’ key events throughmechanism design such as medical committee; meanwhile dramaticallyincrease the salary and welfare treatment of public hospitals’ doctors throughthe reform of hospitals’ charging structure.
(4) Incorporate social responsibility into core work and strategy ofpublic hospitals with evaluation by a third-party evaluation organization;include social responsibility index in the public hospitals’ performance,evaluation, assessment or target management system so as to strengthenhospitals’ and medical care and health practitioners’ sense of socialresponsibility and encourage hospitals to release social responsibility reporton a regular basis.
(5) Strengthen civic education and improve the doctor-patientrelationship. Health authorities need to make publicity with various kinds ofmedia, and let people set up right health care awareness and enrich medicalknowledge, maintain right behaviors of seeing doctors, show respect formedical personnel and be responsible for their own health.
(6) Take measures to enhance the information transparency of publichospitals; advocate the set-up of public relations department in large hospitals,and implement the policy of making government affairs public so as toenable the public learn about the hospitals’ development, operation status andgenuine medical level through various ways, and obtain supports fromstakeholders.
公立医院是社会的一份子，需要为社会尽义务，为其利益相关者如：政府出资人、患者、医务人员和社区等承担相应的社会责任。然而，有关公立医院社会责任的研究在国内尚处于初始阶段，定义和内涵不一、缺乏系统和实证研究。
本论文从最根本的问题着手，重点研究了：
第一、为什么公立医院要承担社会责任？
第二、公立医院社会责任的对象是谁？
第三、公立医院如何实现其社会责任？
第四、如何评价公立医院社会责任？
本论文在充分研究前人相关研究成果的基础上，利用经济学的理论模型与管理学的研究方法，结合对新加坡公立医院改革经验的分析，建立了一套完整的公立医院社会责任理论体系。本论文得出的主要结论和创见是：
1、建立了基于利益链的公立医院社会责任理论体系
本论文首先明确了公立医院是利益创造体的本质，该利益是以利益相关者为基础的社会利益（公益）和赖以发展的经济利益。其次，构造了由利益创造、利益分配和利益保护三个环节所组成的公立医院利益链。公立医院通过对各利益相关者的资源整合与付出，为社会创造利益和价值；完善的治理结构能够为各利益相关者合理分配这些利益，而履行社会责任则是对所有利益相关者应得利益的保护。这将使得各利益相关者有动机创造更大的利益，促进医院价值创造最大化，利益相关者利益分配合理化及最大化，从而实现社会责任。最后，本论文以严谨的递进式逻辑，建立并论证了“基于利益链的公立医院社会责任理论体系”。
2、利用科学方法确定了公立医院利益相关者
本文认为，公立医院利益相关者是公立医院社会责任的对象或受益方，也是医院治理结构的一个关键角色。医院承担社会责任就是实现各利益相关者的利益主张，也就是对利益相关者的利益保护。本文从资源依赖和资源结构理论出发，分析公立医院利益相关者的特殊性，明确了掌握知识和智慧资源的医院高级管理者与医生的核心地位，突破了政府或投资人主宰医院的传统观点。另外，将政府所有职能部门划分为“出资人”和“行业监管部门”两个利益相关者，为医院管办分离打下理论基础。在问卷调查和专家咨询的基础上，采用米切尔属性分析法确定了公立医院的四个核心利益相关者、五个预期利益相关者和两个潜在利益相关者。
3、设计出完善的公立医院利益分配即利益相关者共同治理机制
本文通过建立核心利益相关者利益博弈数学模型得出：公立医院内部核心利益相关者只有通过合作博弈才能够保证医院和自己的最大利益。同时，通过医方与患方博弈模型，确定了医方发出正确信号的重要性。在此基础上，构建了公立医院利益相关者共同治理模型，以实现利益的合理分配。该模型内部要素包括公立医院出资人制度、公立医院产权改革、有公众代表参与的董事会领导下的院长负责制结构以及医生群体的参与方式。外部要素的重点是是政府监管与补偿行为、有管制的市场行为和有导向的患者就医行为。本文也通过作者亲自调查访问得到的四个真实案例，研究政府对公立医院的合理监管方式以及公立医院改革的方向。
4、对公立医院社会责任的概念做了最新界定并设计出科学的评价指标体系
本文公立医院社会责任定义和内涵是：公立医院通过透明、守法和道德的行为，为其决策及活动给利益相关者带来之影响所承担的责任。其主要包括四个方面：效益、法律、道德和慈善责任。本文也采用科学、适宜的方法，包括专家咨询、样本调查和实际测量，以及规范的多元统计学信度和效度分析，得出完整、具操作性和指导性的基于利益相关者的三级共50个项目的公立医院社会责任评价指标体系。
5、对中国公立医院社会责任现状做了大样本调查并分析了影响因素
利用自行设计的评价指标体系，对中国公立医院社会责任现状作了大样本调查，对公立医院履行社会责任所存在的问题和原因作了深入探讨，也论证了中国公众“看病难、看病贵”问题所涉及到的医院内部原因。研究发现，中国公立医院在完成政府所规定的任务方面较为突出，但在提高医院运营效率的精细化管理、所有权与经营权分离的治理改革、医生权益保护以及医院信息透明度等方面还存在严重不足。这些问题引起相应利益相关者不满，转嫁的结果加剧了公众“看病难、看病贵”问题。
本文在理论探索和实证研究的基础上，对中国医疗体制改革提出以下对策建议：
（1）加快组建代表政府的医院出资人机构、统一政府医院出资人制度。
（2）加快制定《公立医疗机构法》，明确公立医院的法人权利、地位和责任，完善治理结构。
（3）重组公立医院现有组织制度，突出医生在医院的地位和利益。
（4）将社会责任融入公立医院核心工作和战略中。
（5）加强公民教育、改善医患关系。
（6）采取措施加大公立医院的信息透明度。
Medical care and health cause is an important link of “people’s livelihood” orsocial security field, the development level of which is remarked by thefairness and accessibility of medical service. Public hospitals invested by thegovernments are the main medical service providers in most of the world’scountries including China. The word “public” in “public hospitals”determines its public benefit characteristic but it is not the entire reason forits existence. Through the studies on the nature of public hospitals and theexploration of the value creation law of hospitals, benefit protection andinfluencing factors should be made to establish a complete set of theoreticalsystem for public hospitals’ social responsibility based on interests-chainhypothesis. In this way, stakeholders of public hospitals will be motivated toinvest more resources, create more value and make the country and the publicbenefit. Meanwhile, it can explain current obstacles facing China’s publichospitals in the operation process, and solve social problems caused byshortcomings of medial system. In the end, it is helpful to the improvementof the country’s medical care and health cause.
Public hospitals, as part of society, need to fulfill their obligations forsociety and shoulder corresponding social responsibilities for its stakeholderssuch as government investor, patients, medical staff and communities.Nevertheless, domestic study on public hospitals’ social responsibility is still at its budding stage with different opinions on its intension and extension,which still lacks of systemic and empirical studies.
This paper starts from those fundamental questions, while puts an focuson the following issues:
First, why do public hospitals need to shoulder social responsibility?
Second, who is the objective of public hospitals’ social responsibility?
Third, how do public hospitals realize their social responsibility?
Forth, how to evaluate the social responsibility?
Main research contents of the chapters are as follows:
This paper starting with the above-mentioned four questions, based onthe adequate study of previous researches in this area, takes advantages ofeconomic theory and models as well as the empirical research in managementstudies, also borrowed the successful experiences of Singapore publichospitals reform, which builds up a complete set of theoretical system onpublic hospitals’ social responsibility.
Main conclusions and innovative opinions obtained by this paper:
1. Establish a theoretical system of public hospitals’ social responsibilitybased on interests-chain.
With rigorous progressive logic, this paper has completely andcomprehensively established and proved the innovative “theoretical systemof public hospitals’ social responsibility based on interests-chain. The mainidea of the theoretical system is: public hospitals integrate and provide resources of stakeholders to create interest and value for society; improvedgovernance structure can reasonably distribute these interests for stakeholderswhile performance of social responsibility means protection of the interestwhich stakeholders deserve. This serves as a motivation for stakeholders tocreate greater interest so as to promote maximization of hospitals’ valuecreation, rationalization and maximization of stakeholders’ interestdistribution and further realize social responsibility.
2. Determine public hospitals’ stakeholders with scientific methods
This paper maintains that public hospitals’ stakeholders refer to objectsor beneficiaries of public hospitals’ social responsibility and are key roles inthe hospitals’ governance structure. Hospitals shoulder social responsibility,which means the realization of stakeholders’ interest claims and protection ofstakeholders’ interest protection. This paper starts with resource dependenceand resource structure theories, analyzes the particularity of public hospitals’stakeholders, clarifies for the first time the core position of seniormanagement teams and doctors of hospitals who possess knowledge andwisdom resources, and goes beyond the traditional view of the government orinvestors’ dominant roles in hospitals. Besides, it divides the government’sall functional departments into two stakeholders of “investors” and“regulatory departments of the industry” for the first time and pave atheoretical way for hospitals’ management offices. Based on questionnairesurvey and expert consultation, it determines public hospitals’ four corestakeholders, five expected stakeholders and two potential stakeholders withMitchell attribute analysis method.
3. Design a complete mechanism for profit distribution in publichospitals or namely the stakeholders’ co-governance mechanism.
This paper uses the game theory method to establish a mathematicalmodel of core stakeholders’ interest game, and infers that public hospitals’internal core stakeholders can only guarantee their interests by cooperativegame. At the same time, this paper infers the importance of the informationtransparence of the hospital through the game model between hospitals andpatients. Based on this inference, the paper discusses and designs a jointgovernance theory and model on the part of public hospitals’ stakeholders.Meanwhile, it studies the best choice for public hospitals’ governance frominternal and external aspects. Internal aspects include public hospitals’investor system, public hospitals’ property right reform, and presidentresponsible system structure led by the board of directors with participationof the public as well as way of doctor representatives’ participation. Externalaspects focus on government regulation and compensation behavior,regulated market behavior and oriented patient behavior of seeing doctors.This paper studies the government’s reasonable regulation of public hospitalsand the reform direction of public hospitals based on four real-life casesdrawn from the author’s personal questionnaire surveys and visits.
4. Provide a new definition of the concept of public hospitals’ socialresponsibility and design a scientific evaluation index system
This paper, based on full studies on previous scholars’ opinions, worksout the definition and connotations of public hospitals’ responsibility whichcomply with the paper’s logic, that is, through transparent, legal and moralpractice, public hospital shoulders the responsibility for the influence brought to its shareholders by its decision and practice. It mainly includes fouraspects, namely, profitability, law, morality, and benevolent responsibility.Meanwhile, it makes an explicit elaboration of four responsibilitiescorresponding to each stakeholder for the first time. This paper also adoptsscientific and appropriate methods such as expert consultation, practicalmeasurement with survey samples and standard reliability and validityanalysis of multivariate statistics to work out a complete, operable andinstructive public hospitals’ social responsibility evaluation index systembased on stakeholders. This is what the previous scholars haven’t touchedupon.
5. Conduct a large-sample survey on public hospitals’ socialresponsibility status in China and analyze influencing factors
This paper conducts a large-sample survey on public hospitals’ socialresponsibility status in China with the author’s self-designed public hospitals’social responsibility evaluation index system, and verifies the correctness ofthe theoretical system through empirical study. Besides, it goes deep into thediscussion of problems existing in public hospitals’ performance of socialresponsibility and causes as well, and provides circumstantial evidence forhospitals’ internal causes for Chinese public’s problem of “difficult access toquality medical services and expensive medical bills”. However, there’smuch left to be desired in such aspects as the delicacy management whichimproves hospitals’ operation efficiency, reform in separated governance ofownership and power of operation, protection of doctors’ rights and interestsand transparency of hospitals’ information. Corresponding stakeholders aredissatisfied with these problems so the transfer of the dissatisfaction exacerbates the problem of “difficult access to quality medical services andexpensive medical bills” for the public.
This paper proposes the following countermeasures and suggestions onChina’s health system reform, based on the theoretical exploration andempirical researches,
(1) Accelerate the establishment of hospitals’ investors organizationwhich represents the government, and standardize the government’s andhospitals’ investors system. The organization should be at the same level withlocal health department (bureau) and a statutory organization of the samenature with corporate interest’s legal representative. It exercises the power ofinvestors, is entitled to interest it deserves and meanwhile shoulderscorresponding responsibility.
(2) Speed up the formulation of “Law of Public Medical Organizations”,clarify the legal rights, position and responsibility of public hospitals,improve the governance structure and let the hospital management teamspossess full operation right with reasonable supervision. Besides,stakeholders should participate in the governance so that their rights andinterests which they deserve can be protected.
(3) Restructure current organizations of public hospitals, highlight theposition and interest of doctors in the hospital; ensure doctors can participatein the decision-making process of the hospitals’ key events throughmechanism design such as medical committee; meanwhile dramaticallyincrease the salary and welfare treatment of public hospitals’ doctors throughthe reform of hospitals’ charging structure.
(4) Incorporate social responsibility into core work and strategy ofpublic hospitals with evaluation by a third-party evaluation organization;include social responsibility index in the public hospitals’ performance,evaluation, assessment or target management system so as to strengthenhospitals’ and medical care and health practitioners’ sense of socialresponsibility and encourage hospitals to release social responsibility reporton a regular basis.
(5) Strengthen civic education and improve the doctor-patientrelationship. Health authorities need to make publicity with various kinds ofmedia, and let people set up right health care awareness and enrich medicalknowledge, maintain right behaviors of seeing doctors, show respect formedical personnel and be responsible for their own health.
(6) Take measures to enhance the information transparency of publichospitals; advocate the set-up of public relations department in large hospitals,and implement the policy of making government affairs public so as toenable the public learn about the hospitals’ development, operation status andgenuine medical level through various ways, and obtain supports fromstakeholders.
引文
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