全民健康覆盖与基层医疗卫生服务能力提升——一个新的理论分析框架

发布时间：2018-11-13 07:52

【摘要】："全民健康覆盖"是全球性医疗卫生系统改革的根本目标。要实现这一目标,关键在于建立健全全民医保体系和以基层为重点的连续性、整合性医疗服务提供体系。我们必须高度重视基层医疗卫生机构在整个连续性、整合性医疗服务体系中的地位与功能,以及其提供初级医疗卫生保健服务的基础作用和核心地位。目前政府与学界都普遍缺乏对基层医疗卫生服务能力的规范性定义和机理性阐释,因此迫切需要提出关于基层医疗卫生服务能力的概念解释与理论分析框架。我们可以在宏观层面将服务能力理解为一种供给与需求相适配的"胜任力",在中观层面分解为结构性、过程性和结果性服务能力,在微观层面进一步细分为服务提供能力、需求吸引能力、组织成长能力和绩效产出结果四个方面。提升基层医疗卫生服务能力的主要路径,在于需求吸引能力和组织成长能力两个关键环节。
[Abstract]:Universal health coverage is the fundamental goal of global health system reform. To achieve this goal, the key lies in the establishment and improvement of the universal health care system and the continuity of the grass-roots level, and the integrated medical service delivery system. We must attach great importance to the status and function of primary health care institutions in the whole continuity and integrated medical service system, as well as their basic role and core status in providing primary health care services. At present, the government and the academic circles generally lack the normative definition and the mechanism rational explanation of the primary medical and health service ability, therefore, it is urgent to put forward the conceptual explanation and the theoretical analysis frame about the basic level medical and health service ability. We can understand service capacity at the macro level as a "competency" that matches supply and demand, decompose it into structural, procedural and resultant service capabilities at the meso level, and further subdivide service delivery capabilities at the micro level. Demand attraction, organizational growth and performance outcomes. The main way to improve the capacity of primary health care service lies in two key links: demand attraction ability and organizational growth ability.
【作者单位】：浙江大学公共管理学院;
【基金】：国家自然科学基金项目“政府购买基本医疗服务的可行性及其运行机制设计:基于浙江省的研究”(71203194)
【分类号】：R197.1

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