县域医共体改革:构建整合型医疗卫生服务体系的中国方案  

County Medical Community Reform:A Chinese Solution for Building an Integrated Medicaland Health Service

作　　者：涂怡欣 郁建兴[1,2] Tu Yixin;Yu Jianxing

机构地区：[1]浙江大学公共管理学院 [2]浙江工商大学

出　　处：《治理研究》2025年第1期81-90,159,共11页Governance Studies

基　　金：教育部哲学社会科学研究重大课题攻关项目“全面建设社会主义现代化国家新征程中加快实现共同富裕研究”(编号:21JZD019);教育部哲学社会科学研究重大专项课题“党的十八大以来促进人的全面发展与共同富裕的经验与成效研究”(编号:2023JZDZ036);教育部人文社会科学研究青年基金项目“紧密型县域医共体对基层卫生服务能力的影响及作用机制研究”(编号:23YJC630166)。

摘　　要：“起源于安徽,发展于山西,拓展于浙江”的县域医共体改革,是中国2009年实施新医改后最重要的强基层政策工具。在地方探索与顶层设计的互动中,县域医共体改革逐渐成为构建整合型医疗卫生服务体系的中国方案。县域医共体改革在提升基层卫生服务能力方面发挥了积极效应,为国际整合医疗卫生服务理论与实践提供了中国经验和中国智慧。县域医共体改革目前仍然存在局限性,主要源于改革的不彻底,而这恰恰指明了县域医共体下一步改革的重点与方向,即以医保支付方式为核心,驱动县域医疗共同体向以人民健康为中心的健康共同体转型。County medical community reform originated in Anhui province, developed in Shanxi province, and even-tually expanded to Zhejiang province. Of all the changes in the field in recent years, it is the most important policy tool forstrengthening the primary-level health system after the institution of 2009’s “ new medical reform”. As a product of the in-teractions between local exploration and top-level design, county medical community reform became China's solution forbuilding an integrated medical and health service system. It has helped improved the capacity of primary-level health serv-ices while adding Chinese experience and wisdom to the theory and practice of international integrated medical and healthservices. The reform’s limitations are mainly due to the incompleteness of the reform, which is the focus and direction ofthe reform’s next step. The goal now should be to transform the medical community into a health community centered onpeople's health with medical insurance payment methods as the core mechanism.

关 键 词：整合型医疗卫生服务体系 县域医共体 基层卫生服务能力 

分 类 号：R197.1[医药卫生—卫生事业管理]