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运用生产函数方法对浙江省三类不同经济水平地区的乡镇卫生院进行规模经济比较研究,表明,经济水平较高和中等的两类地区卫生院的投入产出呈递减规模报酬状态,经济水平较低地区的卫生院呈递增规模报酬状态。提示,在当前的技术经济条件下,前二类地区卫生院宜走“内涵式”发展道路,着重提高内部素质,挖掘内部潜力;第三类地区卫生院应采取“外延与内涵相结合式”发展模式,在适当扩大规模的同时,加强资源合理配置;卫生院尤其是第三类地区卫生院必须加强对生产要素的优化组合。在各种生产要素中,医生是最关键的因素;保持合适数量的床位对卫生院的生存与发展有一定的意义;在当前以自负盈亏为主的补偿机制下,卫生院的财力难以扩大医疗服务。(?)示,经济补偿问题已成为制约卫生院发展的重要因素,亟需在理论上和实践上加以研究解决。
The use of the production function method to compare the economies of scale in township health centers in three different economic levels in Zhejiang province shows that the input and output of health centers in two types of areas with higher economic levels are declining to scale returns, and the economic level is relatively low. Health clinics in the lower regions are on an increasing scale of pay. It is suggested that under the current technical and economic conditions, the first two types of district hospitals should adopt the “connotation-type” development approach, focusing on improving internal quality and tapping internal potential; the third category of district hospitals should take "extension and connotation Combined mode of development, while appropriately expanding the scale, strengthen the rational allocation of resources; health centers, especially the third type of regional health centers must strengthen the optimization of the combination of factors of production. Among various factors of production, doctors are the most critical factor; maintaining a proper number of beds has a certain significance for the survival and development of health centers; under the current compensation mechanism based mainly on self-financing, the health facilities are difficult to expand medical resources. service. (?) shows that economic compensation has become an important factor constraining the development of hospitals, and it is urgently needed to study and solve them theoretically and practically.