我国儿童医疗救助制度伦理研究

发布时间：2018-03-20 20:11

本文选题：儿童医疗救助　切入点：制度伦理　出处：《天津医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：“人人享有基本医疗卫生服务”是我国建设小康社会的重要目标,随着全民健康呼声的上涨,儿童的健康问题己开始引起政府和百姓的关注。作为对于儿童健康的有力保障,儿童医疗保障制度尤其是医疗救助制度的意义尤为重要。然而,受多方面因素的影响与制约,我国儿童医疗救助制度发展滞后,学术界关于儿童医疗救助的研究成果较为欠缺,需要对其进行全面深入的理论探讨和实践探索。本文通过厘定儿童医疗救助的概念,梳理当前我国儿童医疗救助制度的发展历程,全面评价当前我国儿童医疗救助制度建设取得的成效及存在的问题,深入分析造成儿童医疗救助困境的各方面原因,并针对问题的根源提出我国儿童医疗救助制度应有的伦理价值取向以及完善制度的具体措施。其具体内容如下:第一章:笔者对儿童医疗救助的内涵和外延进行了界定,并阐述了相关理论基础,即儿童成长历程理论、第三次分配理论和公正理论;第二章:通过对儿童医疗救助制度的发展历程进行梳理,总结整理当前我国儿童医疗救助的制度安排,并对当前我国儿童医疗救助制度进行评价。在评价中笔者概括了我国儿童医疗救助制度的建设成效,如儿童利益得以重视、制度框架基本形成和医疗保障水平不断提高;同时指出当前儿童医疗救助存在的问题,其中包括儿童医疗救助法律制度缺失、当前儿童医疗救助不能满足现实需求和儿童医疗救助相关管理部门权责不明。第三章:分别从制度的制定层面、制度实施层面和行政管理三个层面探究造成儿童医疗救助困境的原因。造成儿童医疗救助困境的制度制定层面的原因是:①制度制定者对社会救助认识偏差;②儿童医疗救助制度设计中的不公平性。制度实施层面原因是:①医疗救助资金存在绝对不足与相对过剩;②忽视儿童康复、防治救助;③儿童医疗救助制度运行中的地域差异性。行政管理层面原因是:①行政管理分割格局长期存在;②对医疗卫生机构监管乏力。第四章:提出我国儿童医疗救助制度应遵循的伦理价值取向:公正、正义和人道主义,以及相应的伦理价值建设路径。第五章:针对儿童医疗救助制度困境提出完善我国儿童医疗救助制度的具体措施:一是完善儿童医疗救助制度设计,在加快医疗救助立法建设的同时应该注重与相关制度的衔接;二是提升儿童医疗救助能力水平,包括拓展筹资渠道和预防优先,防治结合的措施;三是规范儿童医疗救助管理体制,一方面应注重相关部门之间的协作,另一方面应加强医疗卫生行政监管。
[Abstract]:"access to basic medical and health services for all" is an important goal of building a well-off society in our country. With the rise of the voice of national health, the problem of children's health has begun to attract the attention of the government and the common people. The significance of the child medical security system, especially the medical assistance system, is particularly important. However, due to the influence and restriction of many factors, the development of the child medical assistance system in China lags behind, and the academic research results on the medical assistance for children are relatively lacking. It needs to be thoroughly explored in theory and practice. By defining the concept of medical assistance for children, this paper combs the development course of medical assistance system for children in our country. This paper comprehensively evaluates the achievements and problems in the construction of the current medical aid system for children in China, and analyzes in depth the causes of the plight of medical assistance for children. Aiming at the root of the problem, the author puts forward the ethical value orientation and the concrete measures to perfect the system of medical assistance for children in our country. The specific contents are as follows: chapter one: the author defines the connotation and extension of medical assistance for children. And elaborated the related theory foundation, namely the child growth course theory, the third distribution theory and the justice theory; the second chapter: through to the child medical assistance system development course carries on the comb, In the evaluation, the author summarizes the construction effect of the child medical aid system in China, such as the children's interests can be paid more attention to, in the evaluation, the author summarizes the system arrangement of children's medical assistance in our country, and evaluates the current medical aid system of children in China, if the children's interests are paid more attention to, At the same time, it points out the problems existing in the current medical assistance for children, including the absence of the legal system of medical assistance for children. The current medical assistance for children can not meet the actual needs and the authority and responsibility of the relevant administrative departments of medical assistance for children are not clear. Chapter three: from the level of the establishment of the system, This paper probes into the causes of the plight of children's medical assistance from the three levels of system implementation and administration. The reasons for the establishment of the system for children's medical assistance are as follows: 1, the system makers have a wrong understanding of social assistance, and the other is that the children have a wrong understanding of social assistance. The unfairness in the design of medical aid system. The reason for the implementation of the system is that there is absolute insufficiency and relative excess of medical aid funds in the proportion of 1 to 1, and the rehabilitation of children is neglected. The reason of the administrative level is that the separation pattern of administration and management has existed for a long time, and the supervision of medical and health institutions is weak. Chapter 4th: put forward the medical treatment of children in our country. The ethical value orientation should be followed in the relief system: just, Justice and humanitarianism, and the corresponding path of ethical value construction. Chapter 5th: in view of the plight of the medical assistance system for children, put forward specific measures to improve the medical aid system for children in China: first, perfect the design of the medical aid system for children, In speeding up the construction of medical assistance legislation, we should pay attention to the link with the relevant systems, second, to improve the level of children's medical assistance ability, including expanding funding channels and prevention priority, prevention and treatment of the combination of measures; The third is to standardize the management system of children's medical assistance. On the one hand, we should pay attention to the cooperation between the relevant departments, on the other hand, we should strengthen the administrative supervision of medical and health care.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：D632.1;R197.1

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