医疗保障治理体系现代化与提升路径的系统思考  

The Modernization and Promotion Path of Medical Security Governance System from the Perspective of System Theory

作　　者：谭清立 林岱衡 刘鼎 林蓓佳 TAN Qing-li;LIN Dai-heng;LIU Ding(School of Medical Business,Guangdong Pharmaceutical University,Zhongshan 528400,China)

机构地区：[1]广东药科大学医药商学院,广东中山528400 [2]广东省药品监管科学研究基地,广东广州510008 [3]广东药科大学护理学院,广东广州510000

出　　处：《医学与哲学》2022年第14期38-42,共5页Medicine and Philosophy

基　　金：2021年广州市哲学社会科学“十四五”规划课题(2021GZGJ313)。

摘　　要：依据系统论“结构产生功能、功能带来增效”的逻辑,剖析医疗保障治理体系内核及其实现其现代化的先决条件。分析认为,当下医疗保障治理体系是以国家医疗保障局为调控中心,统筹多方医疗资源,并由系统信息传递机制以及内外协同机制构筑现代化治理体系。而当前存在的主要问题包括难以摆脱线性、垂直的框架;一线农村医疗市场建设滞后与分级统筹效果未及预期;多方权责不清而影响运行效率;系统必要组成部分及彰显决策正义的法律系统有待健全;医防结合的系统边界模糊,协同深度有待进一步加强。According to the logic of system theory that"structure produces function and function brings efficiency",this paper analyzes the core of medical security governance system and the prerequisites for its modernization.According to the analysis,the current medical security governance system is to take the National Medical Insurance Bureau as the control center,coordinate multiple medical resources,and build a modern governance system by the system information transmission mechanism and internal and external coordination mechanism.At present,the main problems include the difficulty to get rid of the linear and vertical framework;the lagging-behind of the construction of front-line rural medical market;the less anticipated effect of hierarchical overall planning;the inefficientoperation affected by the unclear rights and responsibilities of multiple parties;the unsound necessary components of the system and the legal system highlighting the justice of decision-making;the vague system boundary of the combination of medicine and prevention;and the imperfect collaboration.

关 键 词：医疗保障治理体系 治理体系现代化 系统论 药品集中带量采购 医疗公平 

分 类 号：R-05[医药卫生]