| 引用本文：韦潇,代涛,朱晓丽,等.推进医改五项重点工作中的难点问题——部分地市卫生主管领导调查[J].中国卫生政策研究,2010,3(11):30-35 |
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| 推进医改五项重点工作中的难点问题——部分地市卫生主管领导调查 |
| 投稿时间：2010-10-11 修订日期：2010-10-25 PDF全文浏览 HTML全文浏览 |
| 韦潇, 代涛, 朱晓丽, 谢宇 |
| 中国医学科学院卫生政策与管理研究中心 |
| 摘要:目的：通过调查分析部分地市级卫生主管领导在推进医改五项重点工作中存在的困难和问题，及时总结经验，为进一步推进医改工作提供借鉴。方法：对34名地市级卫生主管领导进行问卷调查和访谈，并将所收集的信息进行统计分析和综合归纳。结果和讨论：通过对地方推进五项重点改革工作面临的困难和问题进行重要性排序，可以发现：（1）基本医疗保障制度推进迅速，但存在后续资金不足和资金管理方面的问题；（2）基层医疗卫生服务体系建设成效显著，但人才匮乏成为主要问题；（3）基本公共卫生服务均等化需要进一步制度化、规范化；（4）基本药物制度大有可为，但需集中攻破难点问题；（5）公立医院改革的方向和路径尚不清晰。政策建议：（1）持续、稳定、合理的投入机制是进一步推进改革的基本保证；（2）鼓励地方积极探索，自下而上地探索转化机制的适宜方式；（3）基本药物制度基本确立了综合改革、统筹推进的思路；（4）公立医院改革实践要从统一基本认识出发；（5）重点领域的医改政策解读和研究应更深入和有针对性。 |
| 关键词:医药卫生体制改革 五项重点工作 难点 问题 调查 |
| 基金项目:卫生部政策法规司2010年卫生政策研究快速开发课题 |
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| Analysis on difficulties of five priorities of health care reform——survey for chief executives in some prefecture level cities |
| WEI Xiao, DAI Tao, ZHU Xiao-li, XIE Yu |
| Center for Health Policy and Management, Chinese Academy of Medical Sciences |
| Abstract:Objective: This article is to investigate and analyze the chief executives’ views in prefecture level cities in terms of the achievements and problems of the five priority reform programs, and to timely summary the experience to promote the implementation of health care reform. Methods: The questionnaire survey and interviews for the 34 health chief executives in prefecture level cities are conducted, and the statistical analysis methods and generalization are used to analyze the data and information. Results: After ranking the importance of the difficulties and problems of five priorities of health reform, the study shows that: (1) The basic medical security system is rapidly advancing, but there are still problems in terms of sustainable funding and funding management; （2）The establishment of grass roots health care services system has achieved remarkable progress, but shortage of grass roots professional talents has become the main issue; （3）The institutionalization and standardization of equalization of basic public health services should be taken into further consideration; （4）National essential medicines system has a promising future, which needs to focus on key issues; （5）The direction and path of public hospital reform are not yet clear. Recommendations: （1）Sustainable, stable, and reasonable health financing mechanisms is of essential assurance to the promotion of health reform; （2）The local government should explore ways of health reform, and find the appropriate ways for the transformation mechanism from bottom to top; （3）National essential medicines system has made clear of reform strategies as comprehensive and coordinated; （4）The practice of public hospital reform should be started from the uniformed thought; （5）The interpretations and researches of five priorities of health reform policy should be further developed and more targeted. |
| Key words:Health care reform Five priority reform programs Difficulties Problems Survey |
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