引用本文:峗怡,王林,贺加.基于合理问责框架的卫生政策制定公平性分析——以新医改方案为例[J].中国卫生政策研究,2012,5(8):43-48 |
|
基于合理问责框架的卫生政策制定公平性分析——以新医改方案为例 |
投稿时间:2012-03-23 修订日期:2012-07-17 PDF全文浏览 HTML全文浏览 |
峗怡1, 王林2, 贺加1 |
1.第三军医大学;2.总后勤部科训局 |
摘要:由于卫生资源的有限与卫生需求增长之间的矛盾,近年来卫生政策研究的焦点之一是通过资源分配的优先次序研究,帮助决策者对卫生资源进行有效和公平的分配。从上世纪90年代末开始,合理问责框架逐渐成为保障卫生优先次序分配程序公平性的主导范式之一。本文利用合理问责框架,以新医改政策制定为例对卫生政策制定的公平性进行分析,认为关联、修正/上诉两个条件的公平性较差,公开、执行两个条件从形式上而言具有较好的公平性,但是就实质公平而言仍有可努力的空间。建议加强决策过程的透明公开,实现各利益相关方的参与赋权;提高政府决策能力并落实政治承诺;最后提出建构程序公平的四个路径。 |
关键词:合理问责 卫生系统; 政策制定; 公平性 |
|
Analysis on the perspective equity of health policy making based on accountability to reasonableness framework: A case study of new healthcare reform |
|
|
Abstract:Because of the growing contradiction between limited health care resources and health needs, one of the health policy research focus in recent years is through the setting resources priorities to help policy makers allocate health resources in an effective and equitable way. From the late 1990s, Accountability for Reasonableness(A4R) has become the dominant paradigm of procedural justice in the health allocation priority setting. Through the framework of A4R and based on the case study of health reform plan making process to evaluate the fairness of health policy making. The preliminary evaluation of “Relevance” and “Revisions/Appeals” conditions were far from fair, while the “Publicity” and ”Enforcement” conditions were more fair in appearance but not satisfactory in more detailed substance and essentials.The suggestion is to strengthen the decision making process more transparent to enable the stakeholders participation with empowerment; improve government decision making capacity to fulfill the political commitment; the further proposal is on the construction of fair procedural through four paths. |
Key words:Accountability for Reasonableness Health system Policy making Fairness |
摘要点击次数: 2499 全文下载次数: 2757 |
|
|