《基本医疗卫生与健康促进法》中的基本医疗卫生概念框架  

Interpretation of the Conceptual Framework of Primary Health Care in the Primary Health Care and Health Promotion Law

作　　者：曹艳君 钱熠 张明吉[1] CAO Yanjun;QIAN Yi;ZHANG Mingji(School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China;不详)

机构地区：[1]上海交通大学医学院公共卫生学院,上海200025 [2]杭州师范大学公共卫生学院,浙江杭州310000

出　　处：《中国社会医学杂志》2025年第2期149-153,共5页Chinese Journal of Social Medicine

基　　金：国家自然科学基金项目(72004050)。

摘　　要：目的以《基本医疗卫生与健康促进健康法》为权威蓝本,以其《草案》及其他相关政策等为辅助材料,总结阐释基本医疗卫生制度的概念框架。方法采用微分析、文件分析及阐释学方法对相关法律政策文本进行研读分析、分类梳理并解释。结果“基本制度”是该法案全部内容的共通主旨。政府是基本医疗卫生服务的提供者与最终责任方,并承担了部分支付方的角色。基层卫生机构与专业公共卫生机构均为基本公共卫生服务的提供者,“基本”与“非基本”公共卫生服务的界限还有待明确。基层医疗卫生机构是基本医疗服务的提供者,但该法案模糊了医院在基本医疗服务提供中的角色。疾病的疑难危重程度或医疗技术尖端程度是该法案隐含的划分“基本”与“非基本”医疗服务的判断原则。结论法案对基本医疗卫生服务的内容与提供者界定尚有待明确,推断其原因可能是中国政府的引领责任未受学者关注,且理论框架受到发展阶段的限制。Objective Taking the Primary Health Care and Health Promotion Law as the authoritative blueprint and the Draft and other related policies as supporting materials,we summarized and commented on the framework of the primary health and health system.Methods Micro-analysis,document analysis and hermeneutic methods are used to study,analyze,categorize and interpret relevant legal and policy texts.Results"Primary institutions"is the common theme of all the contents of the Health Law.The government is the provider and ultimately responsible for primary health care,and has assumed the role of a part of the payer.The grass-root health care institutions and specialized public health institutions are both providers of primary public health services,and the boundary between"primary"and"non-primary"public health services should be clarified.The grass-root health care institutions are the providers of primary medical services,but the Act blurs the role of public hospitals in the provision of primary medical services.The degree of difficulty and criticality of a disease and the degree of technical sophistication of a medical treatment are two implicit principles in the Health Law for the classification of"primary"and"non-primary"medical services.Conclusion The Law's definition of the contents and providers of primary health care has yet to be clarified.We suggest that the possible reasons are that the vanguard responsibility of the Chinese government in rea-lity has not been paid attention to by scholars,and the theoretical framework is limited by the stage of development.

关 键 词：基本医疗卫生 概念框架 阐释学 《基本医疗卫生与健康促进法》 

分 类 号：R19-019[医药卫生—卫生事业管理] D912.1[医药卫生—公共卫生与预防医学]