【作者】 王丹丹；

【导师】 李江；

【作者基本信息】 中国医科大学 ， 社会医学与卫生事业管理， 2008， 硕士

【摘要】 目的1998年第九届全国人民代表大会常务委员会第三次会议通过了《中华人民共和国执业医师法》(以下简称《执业医师法》)。《执业医师法》1999年5月1日正式施行,《执业医师法》及后来出台的《执业医师法解释》和《医师资格考试暂行办法》规定了我国执业医师的准入制度(以下简称准入制度),从1999年第一次医师资格考试至今已有10年。经济学理论确实是对经营和管理者有用的工具,怎么样将微观经济学的原理用于普遍实际决策中,用经济学理论进行预测对企业的经理和公共决策者来说都很重要。本文通过结合现状对执业医师准入制度的法经济学分析,从经济学角度分析我国执业医师准入制度实行以来取得的成绩和存在的问题,并提出一些改进的策略建议。资料与方法1、实证分析(1)准入制度的成本——效益分析运用经济学中的成本与效益分析原理,对准入制度产生前后的医师管理情况进行对比。(2)准入制度的定价分析运用微观经济中的垄断市场中定价方法的模型,对准入制度的标准进行分析,得出准入制度的效率。2、规范分析运用经济学理论,提出建议,以期解决如何才是最佳的问题。研究结果通过对准入制度的宏观和微观经济学分析,运用成本——效益分析,垄断市场中的定价和三级价格歧视的理论,对准入制度的效率进行分析,得出入制度的成本和效益;对医师资格法律市场的卖方、买方和商品进行分析。并从这些方面来分析准入制度的效率,得出准入制度取得的成就和存在的问题。讨论实行准入制度结束了我国40多年来医师准入管理无法可依的局面,满足了社会对医师专业化、规范化的要求,净化了医师的执业环境,为保障人民群众的健康做出了巨大的贡献。由于我国的历史情况,在实行准入制度时,一部分医学中等专业学校受到了办学影响,这是由于准入制度的实施,提高了医师的门槛;对医学教育产生的有效影响,这是社会发展所需要付出的必要的代价。2007年执业医师资格考试漏题事件,本质上是由于法的执行成本投入不足,导致考试程序中有漏洞,为不法分子所用,导致了准入制度的不必要代价。专科医师准入制度的缺失,是我国实行准入制度10年后,医师质量得到了提高,我们人民生活水平提高对医疗水平要求更高共同作用的结果,现有的准入制度提供的医师资格价格偏低,导致一部分社会效益不能实现而不能达到效率。结论及建议医师准入制度净化了执业医师队伍,增强执业医师的工作责任心,从而建立起一支业务能力强、专业水平高的执业医师队伍,从根本上提高我国的医疗卫生水平,确保人民群众享受良好的医疗卫生服务。专科医师准入制度的缺失,准入制度程序上的不合理,对医学教育也产生了一些不良影响,根据以上分析,提出以下建议:专科医师培养策略,医学教育政策的调整等。更多还原

【Abstract】 ObjectiveIn 1998, the 3rd meeting of the Standing Committee of the 9th National People’s Congress passed the "People’s Republic of China Medical Practitioners Act", "Medical Practitioners Act" was formally implemented on May 1st, 1999. "Medical Practitioners Act" and the subsequent introduction of "Explanation of Medical Practitioners Act "and the" Interim Procedures for physicians qualifying examination" formed the practitioners accession system . Since1999 the first qualifying examination physician has been held for 10 years.Economic theory is indeed useful tools for the operators and managers, such as how micro-economics will be used for general principles in the actual decision-making. Using economic theory to predict the enterprise managers and public policy makers is very important. In this paper, through a combination of the status quo practitioners accession system made a law and economics analysis from the economics point of view of our practitioners accession system, summarized the achievements and existing problems, and made a number of recommendations to improve the strategy.MethodsPositive and Normative Analysis, Cost and Benefit Analysis and Efficiency theory. Through macro-and micro-economic analysis like cost - benefit analysis , pricing in monopoly market, third-degree price discrimination theory, access to the efficiency of the system, a system of access and cost-effectiveness on the legal market for physicians seller, the buyer and merchandise analysis, and the accession to these areas to analyze the efficiency of the system, the achievements and the problems that exist. DiscussionImplementation of the practitioners accession system ends the situation that there is no rule to follow in China’s access to the physicians access management for over 40 years. It met the specialized physicians and standardization requirements, purified the physician practice environment, made tremendous contribution for people’s health.Because of our country’s history, in the implementation of practitioners accession system, the middle part of the medical professional schools affected in teaching aera, which is due to the implementation of the system access, raising the threshold of a physician; an effective impact to medical education like this is the necessary price required to pay in social development process.2007 practitioners qualifying examination leakage incident, in essence, is due to the implementation of inadequate input costs, resulting in the examination procedure has loopholes for unscrupulous elements to use the access system and in the end led to unnecessary price.Specialist physician access system deficiencies, 10 years after the country implement the access system, is the result of this cause that the doctors has been enhanced quality, the improving living standards of our people demand a higher level of health care. The existing system provides a low prices access to qualified physicians, resulting in the inability to realize part of social benefits to achieve efficiency.ConclusionPractitioners accession system made great improvement for purification of the practitioners, so as to strengthen the work of practitioners responsibility to build a strong, professional practitioners of high ranks, and fundamentally improved China’s medical and health standards to ensure that the people enjoy good medical and health care services.Specialist physician access system deficiencies, unreasonable access procedures on the system of medical education has also produced some adverse effects, according to the above analysis, the following recommendations were made: specialist training strategy, medical education, the adjustment of its policy.更多还原