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“强基层”政策的逆向效果与应对策略——以安徽省肥西县为例
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| 投稿时间： 2015-08-09 最后修改时间： 2015-10-13 摘要点击次数: 2449 全文下载次数: |
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| 引用本文：岳大海, 金音子, 何莉,等.“强基层”政策的逆向效果与应对策略——以安徽省肥西县为例[J].中国卫生政策研究,2015,8(10):19-23 |
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| 岳大海, 金音子, 何莉, 朱炜明, 张鲁豫, 马慧芬, 孟庆跃 |
| 北京大学中国卫生发展研究中心 北京 100191 |
| 基金项目:世界银行资助——OECD以及中等收入国家以人为本的卫生服务案例研究 |
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| | 摘要:目的:分析“强基层”政策在执行过程中的逆向效果以及肥西县的应对措施。方法:在批判性话语分析(Critical Discourse Analysis,CDA)基础上设计了分析框架进行政策分析。结果:“强基层”政策在执行过程中出现了基层积极性降低、部分人员流失、服务能力受到限制等逆向效果,肥西县通过人力提升、网络建设、工作条件和管理机制四方面的改进,以应对出现的逆向效果。结论:基层政府在执行医改政策时,应对政策可能产生的预期和非预期结果进行系统评价,并能因地制宜地采取应对措施,以缓解非预期逆向效果的影响。 | |
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关键词:强基层 逆向效果 肥西县 应对策略
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| Reverse effects of the “primary health care strengthening” policies and their coping strategies: Case study of Feixi county, Anhui province |
| YUE Da-hai, JIN Yin-zi, HE Li, ZHU Wei-ming, ZHANG Lu-yu, MA Hui-fen, MENG Qing-yue |
| China Center for Health Development Studies, Peking University, Beijing 100191, China |
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| | Abstract:Objective: To analyze reverse effects induced in the implementation process of “primary health care strengthening” policies, and the innovative initiatives and countermeasures raised in primary health care system's comprehensive reform of Feixi county. Method: Based on the principles of Critical Discourse Analysis (CDA), this paper designs its analytical framework for policy analysis. Results: Many reverse effects appeared in the implementation process of “primary health care strengthening” policies. However, through improvements in terms of manpower upgrading, network building, working conditions and management mechanisms, Feixi county has successfully strengthened the capacity building for primary health care institutions. Conclusions: The expected and unexpected results should be evaluated systematically when the policies are being implemented, and local governments need to proceed according to local conditions in order to prevent unintended reverse effects from happening. | |
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