| 引用本文：李浩淼, 陈迎春, 张研, 高红霞.基于回应性的健康服务供给体系改革探讨[J].中国卫生政策研究,2020,13(1):31-37 |
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| 基于回应性的健康服务供给体系改革探讨 |
| 投稿时间：2019-07-17 修订日期：2019-12-03 PDF全文浏览 HTML全文浏览 |
| 李浩淼1,3,4, 陈迎春1,2, 张研1,2, 高红霞1,2 |
1. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
2. 湖北省人文社科重点研究基地农村健康服务研究中心 湖北武汉 430030;
3. 武汉大学人民医院 湖北武汉 430060;
4. 武汉大学模式动物研究所 湖北武汉 430071 |
| 摘要:我国当前的健康服务供给体系存在服务利用不适宜、供给效率不高的问题，主要表现在居民就诊趋高、医疗服务利用过度与不足并存、供方服务动力不足等，其桎梏在于当前健康服务供给改革中回应性考量不足。健康服务供给的回应性包括政策对居民的回应性、政策对服务提供方的回应性以及提供方对居民的回应性。政府在制定政策与医疗机构提供服务时，对居民实际需求以及服务利用失衡的形成机理考虑不足、政府政策制定时没有充分把握服务提供方的发展需求、提供方服务方式不符合当前居民非医疗方面的需求水平等。基于服务接触理论，明确政策到行为转变的具体路径，提出政策制定时需要靶向精准，把握居民需求；动态调整，满足供方发展需求；供方需要关注居民多元需求，优化服务体验。 |
| 关键词:健康服务 回应性 服务接触理论 质量 |
| 基金项目:国家自然科学基金面上项目(71974064);中央高校基本科研业务费专项资金资助(2018KFYYXJJ064) |
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| Discussion on the reform of health service supply system based on responsiveness |
| LI Hao-miao1,3,4, CHEN Ying-chun1,2, ZHANG Yan1,2, GAO Hong-xia1,2 |
1. School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science andTechnology, Wuhan Hubei 430030, China;
2. Rural Health Service Research Center, Key Research Base of Humanities and Social Sciences, Hubei Province, Wuhan Hubei 430030, China;
3. Renmin Hospital of Wuhan University, Wuhan Hubei 430060, China;
4. Institute of Model Animals of Wuhan University, Wuhan Hubei 430071, China |
| Abstract:Under the current healthcare service supply system, the utilization of health resources and health service provision is inappropriate, and the service quality is poor. The phenomenon of patients seeking for medical services in tertiary hospitals is prominent, characterized by inappropriate admissions and inadequate service provision. This is due to the fact that in the health service supply process, the responsiveness is doubtful. Most key factors indicating the weakness in responsiveness include the insufficient consideration of the actual needs of patients and the formation mechanism featured by unbalanced service utilization when the government formulates policies and medical institutions provide services, the government lack consideration of the actual needs of the region and residents, and the service providers' dissatisfaction in terms of development needs. Besides, the providers' service mode does not meet the current level of residents' medical and non-medical needs. The responsiveness of health service supply system is characterized by the response of the policy to the residents and to the service providers, and the response of the providers to the residents, which is divided in three classes of responsiveness, namely, policy to residents, policy to service providers, and service providers to residents. Based on the Service Contact Theory, the improvement strategies of the three types of responsiveness were analyzed. Based on the responsiveness and its features, it is suggested to optimize the health service supply system reform through high precision in targeting the policy formulation needs so as to meet the residents' needs, making dynamic adjustments to meet the suppliers' development needs and the suppliers need to pay attention to different needs of residents and optimize service experience. |
| Key words:Health service Responsiveness Service contact theory Quality |
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