| 摘要: |
| ?????? 目的 了解公立医院质量规制的现状，发现问题，研究影响因素，为建立有效的医院规制体系提供依据。方法 通过文献研究、现场调查、专家小组法收集相关数据，运用多元逻辑回归法进行影响因素分析。 结果 医院组织结构保障、医疗机构质量责任意识 、医院管理者的自身素质和管理水平、医院激励机制设计、政府对医院的补偿、有效的监督和真正严厉的惩处制度这6个因素是医院质量规制制度的影响因素。政府财政补偿不足以及医生工资待遇偏低是导致医疗机构忽视医疗服务质量的首要原因，其次依次为缺乏有效的质量监管手段，医院、医生激励机制设计不合理等。结论 政府对医院的补偿不足是影响医院质量规制制度的危险因素，其余为保护性因素。应适当加大政府对医院的财政投入，提高医生的工资待遇，加强对医疗质量的监管，完善医院激励机制。 |
| 关键词: 医疗服务 质量规制 公立医院 影响因素 逻辑回归 |
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| Study on Present Situation, Problems and Influence Factors of the Public Hospital Quality Regulation |
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| Abstract: |
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????? Objective
To provide a basis for the establishment of an effective system of hospital regulation, to understand present situation of the quality regulation of public hospitals, and to find out problems and its influence factors. Methods Literature research, field investigation and Expert Panel were used to collect related data, and multivariate logistic regression was used for influence factors analysis. Results Six factors are influence factors of the hospital quality regulation system, including the sound hospital quality organization structure, medical quality responsibility consciousness, hospital managers own quality and management level, hospital incentive mechanism design ,government’s funding to hospitals, and effective supervision and punishment system. Insufficient government’s input to hospitals and the doctor’s low wages is the primary factor that leads medical institutions to ignore the quality of medical services, followed by the lack of effective quality control means, hospital and doctor’s unreasonable design of incentive mechanism. Conclusion Insufficient government’s input to hospitals is the risk factor that influences hospital quality regulation system，and the rest are protective factors. The government should appropriately increase financial input of hospitals, improve the wages of doctors, strengthen the quality of medical supervision and improve the hospital incentive mechanism. |
| Key words: medical service,quality regulation,public hospital,influence factor,logistic regression |
