剖析我国基本公共卫生服务均等化推进中的问题  

The analysis on problems in the promotion of the equalization of basic public health services in China

作　　者：姜立文[1] 苌凤水[1] 励晓红[1] 汪华 何晓军 马家奇[4] 汤善建[5] 屈卫东[6] 梁鸿[7] 尹爱田[8] 曾伟[1] 李萍萍[1] 郝模[1] 

机构地区：[1]复旦大学卫生发展战略研究中心,上海200032 [2]江苏省卫生和计划生育委员会,江苏南京210009 [3]江西省卫生和计划生育委员会疾病控制处,江西南昌330029 [4]中国疾病预防控制中心,北京102256 [5]复旦大学数学科学学院,上海200433 [6]复旦大学公共卫生学院,上海200032 [7]复旦大学社会发展与公共政策学院,上海200433 [8]山东大学卫生管理与政策研究中心,山东济南250012

出　　处：《中国卫生资源》2015年第1期7-9,46,共4页Chinese Health Resources

基　　金：健康领域社会风险预测治理协同创新中心项目资助;教育部创新团队项目(IRT_13R11);国家社科基金重点项目(13AZD081);国家自然科学基金项目(71373004;71303058);教育部哲学社会科学发展报告资助项目(11JBGP039);教育部高等学校博士学科点专项科研基金资助项目(20120071110055);教育部人文社会科学研究青年基金项目(12YJCZH100);国家卫生和计划生育委员会科研基金资助项目;复旦大学"985工程"三期整体推进社会科学研究资助项目(2011SHKXZD020;2012SHKXQN008)

摘　　要：深入剖析了我国基本公共卫生服务均等化推进中几类关键问题以及问题之间的相互作用关系:(1)认识不清,将"基本公共卫生服务"理解为"基层公共卫生服务",使落实基本公共卫生服务变成"基层"一家之责;将"基本公共卫生服务"代替"公共卫生服务",忽视常规服务项目开展。(2)职能错位,公共卫生服务开展的主体——专业公共卫生机构被"边缘化";职能缺位,项目推进缺乏全流程的职责分工。(3)协调不力,基本公共卫生服务项目推进的效率较低。(4)推进项目开展的工作经费总量不足,分配不均;公共卫生人员的数量、素质均难以满足项目的执行。因此,要有效落实基本公共卫生服务,首先需要扭转错误观念,其次需要建立协调沟通机制、明确全流程的工作内容与职责分工等。A deep analysis on the interaction relationship between the key issues during the promotion of the equalization of basic public health services in our country was conducted：（1）Misunderstanding：the conception“basic public health services”was misinterpreted as“grass-root public health services”,resulting in that the grass-root health institutions became the sole agency responsible for the implementation of the services.“Public health service” was replaced by“basic public health service” and the routine services were neglected to be carried out. （2）Responsibility dislocation：professional public health agencies responsible for providing public health service were marginalized. Responsibility vacancy：the promotion of the basic public health services was lack of clear-defined responsibilities during the implementation process. （3）Poor coordination：the promotion of basic public health services was of low efficiency. （4）The funding was insufficient and the distribution was uneven. The quantity and the quality of the public health staffs can hardly meet the needs of the implementation. Therefore,It is suggested to reverse misconceptions, establish coordination mechanism,and define the service contents and the responsibilities among agencies in the process to effectively implement basic public health services.

关 键 词：基本公共卫生服务 均等化 问题 剖析 

分 类 号：R1[医药卫生—公共卫生与预防医学]