摘要
从2009年"新医改"到2020年"十四五规划",作为一项重要的供给侧改革内容,中国整合型医疗卫生服务体系的建设一直贯穿始终,相关政策也备受各界瞩目。以此为背景,自2017年以来,我们通过对不同层面、部门、地区利益相关人的现场研究,结合文献整理,从历史和地区两个维度,对中国整合型医疗卫生体系的政策演变过程予以全景式阐释,阐述中国整合型医疗卫生服务体系建立的动因、政策过程、模式、内容、成效和问题,并通过设计"医疗组织整合的条件机制模型",揭示医疗组织整合的理论与机制,为国际上医疗卫生服务体系治理和公共组织的高质量发展,提供理论创新、改革路径和中国经验。
The objective of this paper is to demonstrate the policy evolution of China’s Integration of Health Services(IHS),and on this basis,clarify the theoretical mechanism of medical organization integration,which is useful for promoting the development of public management theory,improving the efficiency of health services,and helping constructing high-quality health system.Field research of stakeholders at different levels,combined with literature review was conducted in this research paper.The continuous policy supply of the Chinese Communist Party provides a fundamental guarantee for the success of the reform of HIS in China.The policy supply of central government interacts with local government’s policy experiments.National-level policies are derived from local practices.At the same time,national-level policies enables policy diffusion.According to the"medical organization integration:condition-mechanism model",the degree of integration is affected by factors such as economic development,health resources,financing,transportation and governance.The degree of integration and the corresponding integration model should be in line with the level of socio-economic development.The construction of HIS is an important part of China’s medical reform in the future,which should take the development of new information technology into account.The conclusion of this article is based on limited policy documents and cases.Although these documents and cases are typical and representative,there may be the possibility of missing some important documents or cases,which may affect the conclusion of this article.The theoretical model provides the basis and standards for the integration of medical organizations,which assists policy implementers to choose the proper models,thus improving the efficiency of the use of health resources and the access of health services.With the"medical organization integration:condition-mechanism model",this paper reveals the theories and mechanism of China’s medical organization integration,and provides innovation of theories,reform models and China’s experience for the governance of health system and integration of medical organizations.
作者
王俊
王雪瑶
Wang Jun;Wang Xueyao(School of Public Administration and Policy,Renmin University of China,100872,China)
出处
《公共管理学报》
CSSCI
北大核心
2021年第3期152-167,176,共17页
Journal of Public Management
基金
国家自然科学基金(72042002、72061160491)
2020国家文化名家四个一批人才项目《医疗卫生改革评估研究》。
关键词
整合
医疗卫生
服务体系
政策演变
条件机制理论模型
Integration
Health Services
Health System
Policy Evolution
Condition-Mechanism Model
作者简介
通讯作者:王俊(1976-),男,毕业于中国人民大学,博士,中国人民大学公共管理学院教授,中国人民大学卫生政策研究与评价中心主任,研究方向:卫生政策评估、卫生经济微观评价、医院运行机制分析,Email:cfdrking@126.com;王雪瑶(1995-),女,中国人民大学公共管理学院博士研究生,研究方向:公共政策分析、卫生政策评估。
