| 引用本文：秦才欣, 陈海红, 钱东福.基于公共产品理论的基本医疗服务政策演变分析[J].中国卫生政策研究,2021,14(10):1-7 |
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| 基于公共产品理论的基本医疗服务政策演变分析 |
| 投稿时间：2021-09-24 修订日期：2021-10-15 PDF全文浏览 HTML全文浏览 |
| 秦才欣1,2, 陈海红1,2, 钱东福1,2,3 |
1. 南京医科大学医政学院 江苏南京 211166;
2. 健康江苏研究院 江苏南京 211166;
3. 南京医科大学全球健康中心 江苏南京 211166 |
| 摘要:健康关系到人民群众最核心、最直接的切身利益，基本医疗服务作为健康的最基本保障，更是人人都不可或缺的公共需要。回顾我国建国70余年的历史征程，我国基本医疗服务的政策导向历经了计划经济时期福利性的政策供给（1949—1978年）、改革开放时期偏向市场化的政策供给（1978—2003年）、新时期人人享有的政策供给（2003年至今）三次变革。基本医疗服务政策核心要素历经了“平均—效率—公平”三次变迁。其提供效果也可归纳为低水平平均、严重失衡、迈向新的均衡三个历史阶段。本文从公共产品理论切入探究其政策提供与其客观定位的偏差异同，以期为基本医疗服务的进一步治理提供智识支持。 |
| 关键词:基本医疗服务 政策演变 准公共产品 |
| 基金项目:国家社科基金重点项目（20AZD081） |
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| Analysis of the evolution of basic medical service policies based on the theory of public goods |
| QIN Cai-xin1,2, CHEN Hai-hong1,2, QIAN Dong-fu1,2,3 |
1. School of Health Policy and Management, Nanjing Medical University, Nanjing Jiangsu 211166, China;
2. Nanjing Medical University Institute of Healthy Jiangsu Development， Nanjing Jiangsu 211166, China;
3. Center for Global Health, Nanjing Medical University, Nanjing Jiangsu 211166, China |
| Abstract:Health is of essential and most direct interest to people. Basic medical service, as one of the most basic guarantees for maintaining public health, has been an indispensable public demand to all citizens. Reviewing the over 70 years of People's Republic of China history, we can see that the policy orientation of basic medical services in China has sequentially gone through three times of revolution: the welfare-oriented policy provision during the planned economy period (1949—1978), the more market-oriented policy provision during the reform and opening period (1978—2003), and the for-all policy provision in the new era (2003—). The core elements of basic healthcare service policies have gone through three changes: “average-efficiency-equity”, wherein the policy provision effects can be categorized into three respective historical stages: low-level average, seriously imbalanced, and approaching a new equilibrium. This article explores the similarities and deviations of these basic medical service policies in service provision and objective positioning based on the public goods theory, so as to hopefully provide intellectual and knowledge support for the future management of basic healthcare services. |
| Key words:Basic medical services Policy evolution Quasi-public goods |
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