我国医疗卫生机构集团化改革的动力机制研究  

Research on the Dynamic Mechanism of Health Institution Collectivization Reform in China

作　　者：董建新[1] 卢东民[1] 沈旭慧[1] 吴素雄 DONG Jianxin(College of Medicine,Huzhou University,Huzhou,Zhejiang,313000,China)

机构地区：[1]湖州师范学院医学院,浙江湖州313000 [2]温州大学法学院,浙江温州325035

出　　处：《医学与社会》2022年第5期23-28,共6页Medicine and Society

基　　金：国家社会科学基金资助重点项目,编号为17AZZ011;湖州市科技计划(市校合作)软科学研究项目,编号为2021YSR07;湖州师范学院人文社科类专项项目,编号为2021XJWK02。

摘　　要：当前我国医疗卫生机构集团化改革虽然取得了明显的成效,但真正意义上的长效共同体却始终难以形成,动力机制不完善是重要制约因素。解决动力机制问题是推动改革持续深入发展的关键。通过梳理我国医疗卫生机构集团化改革的历史演进历程,从内部属性动因、外部宏观动因、外部供方动因和外部需方动因4个角度,进行医疗卫生机构集团化改革动力因素分析,对各个具体因素之间的关系脉络和作用机理进行讨论。构建一套动力模型,分析五大动态因素的动力机制,剖析当前我国医疗卫生机构集团化改革动力机制所存在的主要缺陷,提出在改革实践中,既要从宏观上深刻理解两大非动态性因素的深刻内涵,又要遵循客观发展规律;在微观上注重五大动态性因素之间的互动关系,以需求侧为导向,动态调整供给侧结构,优化管理监督机制,在健全政府行政决策和社群民主监督机制的同时,适度引入市场竞争机制,探索基于行政、社群和市场三者相互嵌入的协同式医疗卫生机构集团化改革模式。Although Chinese medical and health institution collectivization reform has achieved relatively obvious results, it is still difficult to form a long-term community in the true sense, and the imperfect dynamic mechanism is an important restrictive factor. Solving the problem of dynamic mechanism is the key to promoting the continuous and in-depth development of reform. This paper briefly sorted out the historical evolution of health institution collectivization reform in China, and analyzed the driving factors of health institution collectivization reform from four perspectives: internal attribute drivers, external macro drivers, external supply-side drivers and external demand-side drivers. The relationship between the factors and the mechanism of action were discussed. A set of dynamic models were constructed, dynamic mechanism of 5 dynamic factors was analyzed, and the main defects of the current dynamic mechanism of the health institution collectivization reform in China were analyzed. In the reform practice, we should not only understand the profound connotation of the two non-dynamic factors from the macro perspective, but also follow the objective law of development. At the same time, it is necessary to pay attention to the interaction between the 5 dynamic factors from the micro level, take the demand side as the orientation, dynamically adjust the supply side structure, optimize the management and supervision mechanism, and improve the government administrative decision-making and socialenvironment. Group democratic supervision mechanism, the market competition mechanism should be appropriately introduced to explore a collaborative health institution collectivization reform model based on the mutual embedding of administration, community and market.

关 键 词：医疗卫生机构 集团化 动力机制 

分 类 号：R197[医药卫生—卫生事业管理]