| 引用本文：杨赐然, 崔丹, 孙玉, 毛宗福, 乐梅, 李劲松, 文小桐, 黄超, 刘雨欣.基于共同生产理论的医疗保障经办服务一体化建设研究——基于G县的案例分析[J].中国卫生政策研究,2023,16(7):16-22 |
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| 基于共同生产理论的医疗保障经办服务一体化建设研究——基于G县的案例分析 |
| 投稿时间：2023-05-16 修订日期：2023-06-20 PDF全文浏览 HTML全文浏览 |
| 杨赐然1,2, 崔丹1,2, 孙玉3, 毛宗福1,2, 乐梅4, 李劲松5, 文小桐1,2, 黄超6, 刘雨欣1,2 |
1. 武汉大学公共卫生学院 湖北武汉 430071;
2. 武汉大学全球健康研究中心 湖北武汉 430072;
3. 武汉大学护理学院 湖北武汉 430071;
4. 荆州市医疗保障局 湖北荆州 434020;
5. 荆州市公安县医疗保障局 湖北荆州 434300;
6. 湖南中医药大学人文与管理学院 湖南长沙 410218 |
| 摘要:医保经办服务体系是提升医疗保障制度治理有效性的重要手段。本文以G县为例，基于共同生产理论，深入探讨了医保经办服务一体化建设的过程及其复杂性。分析发现，在驱动医保经办服务一体化建设中，多元的需求性、公平性、整体性和环境性等因素起到了关键的触发作用；公众需求反馈、政府政策推动、服务提供者创新和环境积极影响共同构建了一个动态、互动的共同生产过程。此外，本研究还揭示，在G县医保经办服务一体化建设中存在五种重要的机制，分别是：价值目标构建机制、多方参与合作机制、绩效考核激励机制、公众反馈调试机制和技术创新赋能机制。这些机制既揭示了共同生产理论在解释公共服务创新过程中的有效性，同时也可以为其他地区或领域的共同生产实践提供有益借鉴。 |
| 关键词:医保经办服务 一体化建设 共同生产 案例分析 |
| 基金项目:比尔及梅琳达·盖茨基金会(OOP1148464；OPP1199760)；湖北省医疗保障“十四五“规划中期评估课题 |
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| Study on the integrated construction of medical insurance handling service based on the theory of co-production perspective:Based on the case analysis of G county |
| YANG Ci-ran1,2, CUI Dan1,2, SUN Yu3, MAO Zong-fu1,2, YUE Mei4, LI Jing-song5, WEN Xiao-tong1,2, HUANG Chao6, LIU Yu-xin1,2 |
1. School of Public Health, Wuhan University, Wuhan Hubei 430071, China;
2. Global Health Institute, Wuhan University, Wuhan Hubei 430072, China;
3. School of Nursing, Wuhan University, Wuhan Hubei 430071, China;
4. Jingzhou Healthcare Security Bureau, Jingzhou Hubei 434020, China;
5. Gong'an Healthcare Security Bureau, Jingzhou Hubei 434300, China;
6. College of Humanities and Management, Hunan University of Traditional Chinese Medicine, Changsha Hunan 410218, China |
| Abstract:Medical Insurance Handling Service (MIHS) system is crucial for enhancing the effectiveness of health security system governance. This study discusses the processes and complexities of integrated construction of the MIHS (ICMIHS) based on the theory of co-production, taking G County as an example. The analysis reveals that diverse demands, equity, integrity, and environmental considerations critically trigger the process of ICMIHS. Moreover, a dynamic, interactive co-production process is built, relying on factors such as public demand feedback, government policy initiatives, innovative service provision, and impacts of positive environments. Furthermore, the study uncovers five fundamental mechanisms during the construction of County G's ICMIHS: value goal construction mechanism, multi-party collaboration cooperation mechanism, performance-based incentive mechanism, public feedback debugging mechanism, and technological innovation empowerment mechanism. These mechanisms not only reveal the effectiveness of co-production theory in elucidating the process of public service innovation, but offer valuable insights for co-production practices in other regions and domains. |
| Key words:Medical insurance handling service Integrated construction Co-production Case analysis |
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