Currently, the competent authorities and the financial sector propose that public hospitals should firstly select pilot for key projects, and steadily to expand the implementation scope of financial assistance expenditure budget performance management. By using the example of Tongji Hospital, the current status and problems of budget performance management for public hospital financial assistance expenditure is analyzed, the expenditure budget performance management after received financial assistance is discussed.

By using literature review, expert consultation and investigative method, this paper aims to analyze the progress, system design and implementation for the performance management of financial budget projects in public hospitals. Budget management is still in its initial stage, the management system is imperfect, the index system, in-formation system, and personnel team lag behind expectations. The paper suggests the following measures:theory ho-rizons should actively carry out relevant academic research, the National Health and Family Planning Commission should learn the real state of performance management of pilot financial budget projects in public hospitals and under-stand the progress, highlights, and problems thereof to improve the direction and design of the project performance e-valuation index, provide various scientific and reasonable evaluation index weights, scores, and clear evaluation cri-teria, and thus form a unified budget performance management system framework.

This paper introduces the experience of performance-oriented finnacial compensation in the public hospitals of typical countries. It introduces the setting of performance goals;monitoring and evaluation of financial as-sistance expenditure budget implementation;and provision of funds based on output and task. Problems such as low compensation and based on staffs and beds basis of public hospital financial compensation are analyzed. Finally, the paper provides some enligtenment to improve public financial compensation mechanism: strengthening performance goal management, increasing the scientific level of public hospital budget, implementing budget performance evalua-tion, item and disease cost accounting to specify the compensation way, quota and standard.

The paper analyzes from the angles of the parties providing, needing and paying for medical and health services the factors influencing the medical insurance system and discusses the features of reform directions in the medical insurance payment system, viz. the move of payment from an open to a closed mode and from a single to a mixed mode and the move of the main bodies controlling medical insurance expenses from expenses controlling centers to resources controlling centers. The single mode of payment by service procedures adopted in the current medical insurance system in China must therefore be replaced by a diversified mode of payment and corresponding supporting measures ought to be taken. In the meantime, hospital medical cost accounting ought to form a system that includes department cost accounting, medical procedure cost accounting and disease entity cost accounting.

Constructing a harmonious hospital shares an important role in constructing a harmonious socialist society.Ethical factors are not only the foundation of constructing a harmonious hospital,but also the inherent requirement of clinical practice as well as the consistent goal and means of modern hospital management.Construction of a harmonious hospital in the new situation should embark from the hospital connotation construction,develop a top-grade group of medical staff,build up a transparent charging system,construct a graceful medical environment,search society public opinion support for strengthening mutual communication between doctors and patients,and reconstruct mutual trust between doctors and patients.

The Chinese public hospitals,obviously known from their name,should be national property.However,the current operational behaviors of public hospitals are quite mercantilistic.As far as the approach to the reform and development of public hospitals is concerned,neither should the approach be purely based on public welfare nor the market itself.Instead,a certain degree of marketization on the basis of public welfare together with the integration of public mechanism and market mechanism should be advocated.

From its motivator function of salary system,hospital managers can transform salary into incentive factors to promote hospital's strategy and core value.The author suggests that single-faceted pursuit for economic benefits should be avoided in hospital performance management.Under the precondition of patient-centered and quality-cored medical service,the new way of bonus allocation integrated medical quality,cost consumption,workload and management indicators to inspire medical staff and promote hospital management and development.

An effective hospital performance appraisal system is still unavailable in China,which results in low efficiency of hospital operation to some degree.It is of great significance to carry out hospital performance appraisal for perfecting hospital performance appraisal system and promoting the efficiency of hospita1 management.Some issues should be bared in mind during the establishment of hospital performance appraisal system as follows.Single-faceted pursuit of economic benefits should be avoided.Combination of external hospital appraisal system and internal hospital appraisal system,and the overall application of performance appraisal in performance management should be stressed.It is also suggested to establish a three-leveled performance appraisal system including hospital level,department level and post level appraisal systems.We also argue that attention should be given to the selection of comprehensive appraisal methods,continuous mutual communication on performance,and timely adjustment.

Reasons why the current physician-patient relationship has not advanced to a truely harmonious stage in our country are multiple.From the ethical point of view,most medical disputes come from the lack of sincerity and humane care,and self-centered and economic benefits oriented concepts from both doctors and patients.From the legal point of view,the research on the important legal cases related to physician-patient relationship is hysteretic and even lacking.The system settling physician-patient conflict is distempered and imperfect.Both the doctors′ and patients′ legal knowledge and consciousness are inadequate.To construct a harmonious physician-patient relationship,we should fasten the process of legislation,protect profits on both sides,strengthen moral education and confirm the ethical demand.

The poor population suffers high disease-related economic risk,while holds weak anti-risk capacity,thus is easy to be in the vicious circle of disease-poorness-disease.For many years,disease-related economic risk of the poor remained unsolved,as a result of insufficient health resource and limited medical security capacity.It concludes that the establishment of a medical security system,with joint sharing of risks in bearing the burden of medical expenses,could be a fundamental solution to the disease-related economic risk of poor population.