我国优质医疗资源扩容改革主体行为逻辑和机制优化——基于行动者中心制度主义的分析  

The logic of actors'behavior towards the reform for high quality medical resources dilatancy and the mechanism optimization:from the perspective of Actor-Centered Institutionalism

作　　者：曹琦[1] 严则金 CAO Qi;YAN Ze-jin(School of Public Administration and Policy,Renmin University of China, Beijing 100872, China)

机构地区：[1]中国人民大学公共管理学院,北京100872

出　　处：《中国卫生政策研究》2022年第2期1-10,共10页Chinese Journal of Health Policy

摘　　要：优质医疗资源扩容是国家区域协同发展和公共服务均等化的重大战略要求。为实现医疗资源扩容,中央全面深化改革委员会提出建设区域医疗中心这一创新性制度安排;《中华人民共和国国民经济和社会发展第十四个五年规划和2035年远景目标纲要》再次提出“加快建设区域医疗中心”。在现阶段,区域医疗中心试点是否得到有效推进是改革亟需关注的问题。本文基于行动者中心制度主义,以行为主义分析为起点构建优质医疗资源扩容改革主体行为框架,就改革涉及的行动者互动关系和博弈过程进行解构。在此基础上,本文将分析制度设置对主体行为模式的影响,系统挖掘和剖析行为逻辑背后的制度机理,回应改革深层次制度问题,提出改革优化建议,以期为实现优质医疗资源均衡配置、推动医疗服务体系高质量发展提供借鉴。In order to achieve the national strategic objectives for coordinated regional development and public service equality,dilatancy of quality medical resource is a must to be done.The Central Committee for Deepening Overall Reform had proposed that“regional medical centers planning”would be the core policy arrangement to facilitate high quality medical resource flowing and expanding.“The 14th Five Year Plan”emphasized on accelerating establishment of regional medical centers.How the regional medical centers planning has been implementing?This is a recent policy highlight requires research attentions.Based on the theoretical framework of actor-centeredinstitutionalism,this paper will conduct behavior analysis to find out the interaction between actors and their gaming process.Based on which,we will examine how the actors involved reacting to the reform policy and how the institutional settings impact on the actor behaviors in turn.And finally,this paper will define the institutional deficiencies that need to be improved and provides policy suggestions.

关 键 词：优质医疗资源扩容 区域医疗中心 行动者中心制度主义 行为逻辑 

分 类 号：R197[医药卫生—卫生事业管理]