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Promoting Construction and Development of Three-Tier Guidance System of Balanced Essential Public Health Service in Sichuan Province

医疗体制改革下的医院后勤经营化管理

新一轮医药卫生体制改革（新医改）一系列措施的出台对医院经营管理带来了明显的影响，而医院后勤作为医疗服务的配套保障部门在新医改背景下也面临如何适应与发展的问题。在近几年的医院后勤改革中，社会化被认为是医院后勤服务质量和成本的根本解决之道。但在实践过程中，很多医院将社会化简单地理解为形式上社会化，即仅仅采用承包、外包、托管等形式上的转变而没有在管理上实现真正的社会化。就如医疗卫生服务不能纯粹商品化一样，医院后勤作为支持医院发展的重要保障体系也不能一概用纯粹市场化的方式去运作，医疗卫生服务的公平性、公益性在医院后勤管理中同样需要体现。所以，真正的社会化应该是在管理理念、方式、方法以及服务质量、价格与社会接轨的社会化，而这样的社会化必须改变传统的医院后勤管理理念与模式。医院后勤部门不应作为行政部门来运行管理，而是应作为一个医疗服务的延伸行业进行管理与经营，也就是所有医院后勤部门及业务应象企业一样进行经营，这正是四川大学华西医院近年来推行的后勤经营化管理理念。

Preliminary exploration on the construction of “province, city, county, village” four-level hierarchical medical system in Yibin city

The Second People’s Hospital of Yibin was taken over by West China Hospital of Sichuan University into its close hospital alliance, and simultaneously undertook the task of construction of regional hospital alliance in Yibin city. The article introduces the experiences of the Second People’s Hospital of Yibin in the high-quality development of novel healthcare system. Led by West China Hospital of Sichuan University and based on all-level medical institutions in Yibin, the Second People’s Hospital of Yibin preliminarily established a four-level hierarchical medical system as “province, city, county, village” model, according to the guide of governments within the whole region. It aims to propose a “Yibin model exploration” in hospital alliance construction based on the western regional situation.