结构性视角下中国居民卫生服务需要理论建构与实践向度  

Theoretical construction and practical dimensions of residents′healthcare service needs in China–from a structural perspective

作　　者：贺睿博 刘雪娇[3] 邢怡青 张亮[1] HE Ruibo;LIU Xuejiao;XING Yiqing;ZHANG Liang(School of Political Science and Public Administration,Wuhan University,Wuhan,Hubei 430072,China;Collaborative Innovation Center for Healthcare Insurance Reform,Hubei University of Economics,Wuhan 430205,China;School of Medicine and Health Management,Huazhong University of Science and Technology,Wuhan,Hubei 430030,China)

机构地区：[1]武汉大学政治与公共管理学院,湖北武汉430072 [2]湖北经济学院医疗保险改革协同创新中心,武汉430205 [3]华中科技大学医药卫生管理学院,湖北武汉430030

出　　处：《中国公共卫生》2024年第7期892-898,共7页Chinese Journal of Public Health

基　　金：国家自然科学基金青年项目(72104073);国家自然科学基金重点项目(71734003)。

摘　　要：卫生服务需要作为医疗卫生服务系统存在与发展的基石,对其认识的偏颇和“失真”将导致需方行为解释的局限性,以及影响供方建设方向与资源配置的有效性。针对此,本文在不同学科对于需要概念辨析的基础上,结合我国医疗卫生服务提供方和使用方的特性,界定出卫生服务需要的基本内涵与核心属性;并通过新时代背景因素对居民卫生服务需要的作用方式和作用结果分析,得出卫生服务需要的结构变量;在此基础上,进一步提炼、归纳形成我国居民卫生服务需要的“源起–结构”理论模型。对于服务使用方而言,该模型揭示了需方行为背后的逻辑与分析的步骤、侧重点;对于服务提供方而言,该模型既能够为不同主体之间理清功能定位、优化资源配置、明确发展路径提供理论指导,又是提升服务能力、调整服务结构、改善管理流程的参照依据。Healthcare service needs,as the cornerstone of the existence and development of the healthcare service system,if misunderstood or"distorted",will lead to limitations in the interpretation of demand-side behavior and affect the effectiveness of supply-side construction direction and resource allocation.In response to this,based on the analysis of the concept of needs in different disciplines and combining the characteristics of healthcare service providers and users in China,this paper defines the basic connotation and core characteristics of healthcare service needs.By analyzing the ways and results of the influence of factors in the new era on residents′health service needs,the structural variables of health service needs are derived.On this basis,a"source-structure"theoretical model of Chinese residents′healthcare service needs is further refined and summarized.For service users,this model reveals the logic and steps behind the demand behavior and the focus of analysis.For service providers,this model can provide theoretical guidance for clarifying functional positioning among different units,optimizing resource allocation,and defining development paths,as well as serve as a reference for improving service capabilities,adjusting service structures,and improving management processes.

关 键 词：结构性视角 卫生服务需要 要素分析 理论模型 应用逻辑 

分 类 号：R197.1[医药卫生—卫生事业管理]