“三医”协同:中国健康治理的改革路径  

Medical Service & Basic Insurance & Drug Management Synergy:Reform Pathways for China's Health Governance

作　　者：刘晓婷[1] 吕豪 LIU Xiaoting;LV Hao(School of Public Affairs,Zhejiang University,Hangzhou 310058 China)

机构地区：[1]浙江大学公共管理学院,浙江杭州310058

出　　处：《浙江工商大学学报》2025年第2期12-24,共13页Journal of Zhejiang Gongshang University

基　　金：国家社会科学基金重大专项“促进养老事业和养老产业发展的政策和机制研究”(24ZDA092);国家自然科学基金重点项目“提升基层医疗卫生服务能力研究”(71734005)。

摘　　要：“三医”协同作为中国医药卫生体制改革的重要创新,通过制度重塑、利益整合和治理网络构建,形成了以协作共治为核心的医药卫生治理共同体。深入探讨中国“三医”协同治理的理论内涵、历史演进、实践路径及其面临的挑战与未来发展方向,对指导未来医药卫生体制改革意义重大。从“三医”联动到“三医”协同,体现了中国医药卫生体制改革治理思路的转型;福建省三明市和浙江省德清县的医改实践,分别强调了以行政主导、医药突破和市场调节、医保治理为核心的不同改革路径。未来“三医”协同的发展方向,包括建立多元复合的医保支付体系,增强社群机制在医药卫生治理中的作用和推进价值医疗及医保价值付费,推动从以疾病治疗为中心向以人民健康为中心的转变。Medical Service & Basic Insurance & Drug Management Synergy is an important innovation in the reform of China's medical and health system.Through institutional restructuring,interest integration,and the establishment of governance networks,it has formed a community of medical and health governance centered on collaborative co-governance.An in-depth exploration of the theoretical connotations,historical evolution,practical pathways,challenges,and future directions of this synergy is of great significance for guiding future reforms of the medical and health system.The shift from “tri-med linkage” to “tri-med collaboration” reflects a transformation in the governance approach of China's health system reform;the healthcare reform practices in Sanming City of Fujian Province and Deqing County of Zhejiang Province emphasize different reform pathways,including administrative leadership,breakthroughs in medicine combined with market regulation,and health insurance governance.Future directions for the development of this synergy include establishing a diversified and composite health insurance payment system,enhancing the role of community mechanisms in medical and health governance,and promoting value-based healthcare,thereby achieving a transition from a diseasetreatment-centered approach to one that is centered on people's health.

关 键 词：“三医”协同 医药卫生体制改革 利益相容 健康治理 

分 类 号：R197.1[医药卫生—卫生事业管理]