隶属关系视角下村级卫生组织治理模式探析  

The governance model of village-level health organizations from the perspective of administrative subordination

作　　者：李云萧 韩丹 侯贵林 高红霞[2,3] 沈岚 LI Yun xiao;HAN Dan;HOU Guilin;Gao Hongxia;SHEN Lan(Department of Personnel,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China;School of Medical and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China;Research Centre for Rural Health Service,Key Research Institute of Humanities&Social Sciences of Hubei Provincial Department of Education,Wuhan,Hubei 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院人事处,湖北武汉430030 [2]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [3]湖北省人文社科重点研究基地农村健康服务研究中心,武汉430030

出　　处：《中国农村卫生事业管理》2022年第4期262-266,272,共6页Chinese Rural Health Service Administration

摘　　要：目的探究村级卫生组织在不同时期的隶属关系,为家庭医生政策的推行、基层卫生治理体系建设提供理论参考。方法采取文献及政策文件研究、案例分析方法,结合村级卫生组织的地方治理经验,梳理不同时期村级卫生组织的隶属关系。结果村级卫生组织的治理模式因农村经济基础的变化和地区差异存在不同,理论上在政府和乡镇卫生院两大治理主体下,可存在多种治理模式,但是不同的模式各有弊端,诸如跨领域管理、效率低下、利益对立等。结论针对村级卫生组织隶属关系和治理现状,在构建基层卫生治理体系目标下,紧密型乡村一体化、乡村医生职业化以及乡村医生协会的建立,为村级卫生组织治理提供了新的视角。Objective To explore the administrative subordination of village-level health organizations in different periods,and to provide theoretical references for the implementation of family doctor policies and the construction of primary health governance systems.Methods We adopted literature and policy document review and case analysis to sort out the administrative subordination of village-level health organizations in different periods in combination with the local governance experience.Results The governance models of village-level health organizations varied due to changes in the rural economic foundation and regional differences.In theory,under the two governance bodies of the government and township health centers,multiple governance models could be formed,but all models had their respective drawbacks,including cross-sectoral management,low efficiency,and conflicting interests.Conclusions Targeting the administrative subordination of village-level health organizations and the governance status,under the goal of building a grassroots health governance system,compact township-village integration,rural doctors’professionalization and establishment of rural doctor association can provide a new governance perspective for village-level health organizations.

关 键 词：村级卫生组织 隶属关系 治理 乡村一体化 

分 类 号：R197.61[医药卫生—卫生事业管理]