| 引用本文：傅鸿鹏,苏健婷,单楠,等.我国城市社区卫生服务与医疗保险制度衔接机制研究[J].中国卫生政策研究,2009,2(9):53-60 |
|
| 我国城市社区卫生服务与医疗保险制度衔接机制研究 |
| 投稿时间：2009-08-13 修订日期：2009-08-20 PDF全文浏览 HTML全文浏览 |
| 傅鸿鹏, 苏健婷, 单楠, 党勇, 赵琨, 杨洪伟 |
| 卫生部卫生经济研究所 |
| 摘要:目的：分析城市社区卫生服务与医疗保险制度（以下简称社区医保）衔接中的问题，探索促进衔接的方法策略。方法：通过专家咨询、问卷调查法收集资料，采用机构间合作模式和主题框架法进行分析评价。结果：我国社区医保衔接机制处于发展中合作较低水平。在治理结构上缺乏集权化和有效的领导方式，政策环境缺乏对创新的支持；卫生、医保部门在目标上存在分歧，互信程度不高；工作中缺乏规范化的管理程序，合作技术方案不够健全。结论：建议加强体制改革，建立大卫生体制；推进运行机制改革，根据社区卫生特点改进社区医保技术方案；促进部门沟通合作；加强业务管理。 |
| 关键词:社区卫生服务 医疗保险制度 合作模式 主题框架分析 |
| 基金项目:中澳卫生与艾滋病项目（编号：HSS21） |
|
| A study on cooperation mechanism of community health service and health insurance system in urban China |
| FU Hong-peng, SU Jian-ting, SHAN Nan, DANG Yong, ZHAO Kun, YANG Hong-wei |
| China Health Economics Institute |
| Abstract:Objectives: This article aims to analyze the cooperation mechanism of the community health services(CHS) and health insurance system in urban China, and develops methods or strategies to promote cooperation. Methods: Data was collected through the expert consultation and questionnaire investigation. Structure Model of Collaboration and Thematic framework analysis were used to analyze the material. Results: The cooperation mechanism evaluated as a low level of developing collaboration. In terms of the governance dimension, the centrality and leader mechanism were insufficient and incapable, as well as lack of support environmental to policy innovation. Regarding the shared goals and vision dimension, the two departments just have some nominal common goals and the difference was significant during policy implementation. Mutual acquaintance and confidence was relatively week. Analysis of the Formalization dimension shows that the norm and standard hasnt established successfully. Community health insurance policy still needs to improve. Conclusion: To improve the cooperation mechanism, the first thing to do is to establish a general health governance department to combine health sector and insurance sector. The second is to improve operation mechanism and to make policy according to CHS need. The third is to establish communication mechanism among health sector and insurance sector by using norm and standard to strengthen management. |
| Key words:Community health service, Medical insurance system, Structural model of collaboration, Thematic framework analysis |
| 摘要点击次数: 2915 全文下载次数: 2981 |
|
|
