| 引用本文：龚曦, 王红波.整体性治理视域下多层次医疗保障体系的概念厘定、发展困境及路径选择[J].中国卫生政策研究,2024,17(2):1-8 |
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| 整体性治理视域下多层次医疗保障体系的概念厘定、发展困境及路径选择 |
| 投稿时间：2024-01-02 修订日期：2024-01-31 PDF全文浏览 HTML全文浏览 |
| 龚曦1,2, 王红波3 |
1. 中国人民大学公共管理学院 北京 100872;
2. 中国人民大学健康保障研究中心 北京 100872;
3. 山西医科大学管理学院 山西晋中 030600 |
| 摘要:多层次医疗保障体系内涵不清晰及治理碎片化使医疗保障高质量发展受到挑战。文章以整体性治理理论对多层次医疗保障体系概念内涵进行厘定，从制度的本质属性及直接功能角度区分了托底层、基本层和补充层，并对各层次及其所含子制度间的关系做了阐释。进而从整体性治理视域检视了当下实践，发现碎片化管理思维主导、子制度功能定位不清、政策协同性不足、参与主体单一、平等协商机制缺乏等困境制约着多层次医疗保障体系的整体效能，需要从整体性治理视角采取系统性、针对性改革予以完善。 |
| 关键词:整体性治理 多层次医疗保障 碎片化 政策协同 |
| 基金项目:中国人民大学“中央高校建设世界一流大学(学科)和特色发展引导专项资金”支持项目；国家社会科学基金(22BRK037) |
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| The conceptual definition, development dilemma, and path selection of a multi-level healthcare security system under the perspective of holistic governance |
| GONG Xi1,2, WANG Hong-bo3 |
1. School of Public Administration and Policy, Renmin University of China, Beijing 100872, China;
2. Health Security Research Center, Renmin University of China, Beijing 100872, China;
3. School of Management, Shanxi Medical University, Jinzhong Shanxi 030600, China |
| Abstract:The unclear connotation and fragmented governance of the multi-tiered medical security system pose challenges to its high-quality development. This article redefines the concept and connotation of the multi-tiered medical security system using holistic governance theory. It distinguishes the bottom layer, basic layer, and supplementary layer from the perspective of the essential attributes and direct functions of each system. Furthermore, from the perspective of holistic governance, the article analyzes the current reform practice and finds that fragmented management thinking, unclear positioning of sub-system functions, insufficient policy coordination, single participation subject, and lack of equal negotiation mechanisms are constraints on the overall effectiveness of the multi-tiered medical security system. Therefore, it is necessary to adopt systematic and targeted reform measures from the perspective of holistic governance to improve the system. |
| Key words:Holistic governance Multi-level healthcare security system Fragmented Policy coordination |
| 摘要点击次数: 1060 全文下载次数: 325 |
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