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笔者随中国卫生经济网络组织的广东省卫生改革考察组行程1400公里,考察了14个卫生行政机构和近40个卫生服务组织,感触颇深,主要有以下几点:其一,政府在公共货物和外延效益好的卫生服务方面的职能与作用不因经济发展水平的不同而不同,政府对卫生机构的宏观调控能力来自于财政状况及自身的职能转变;政府对贫困地区的卫生投资是减少贫困的有效途径之一。其二,随着经济的发展需求的变化,卫生服务机构应及时提供与之相应的卫生服务,并为因需求变化可能出现的新需求作好提供服务的准备;政府(卫生行政)则应从供方控制的角度抑制因过多供给而牵拉出的需求和诱导需求。其三,对于富裕起来的农村,政府仅提供基本医疗保证,其他服务的提供则由市场决定;在保障制度方面,政府则应着力于建立大病风险共担的机制而不是停留在基本医疗服务的提供上。其四,对慢性非传染性疾病多发的城市,政府在卫生政策和计划上可着力于扶持推广社区卫生服务。
The Guangdong Provincial Health Reform Inspection Group organized by the Chinese Health Economic Network traveled 1,400 kilometers. It inspected 14 health administration agencies and nearly 40 health service organizations. The feelings were deep and there were the following main points: First, the government in public goods. The functions and roles of health services with good and effective extensions are not different depending on the level of economic development. The government’s ability to regulate and control health institutions comes from the financial situation and changes in their own functions; the government’s investment in health in poverty-stricken areas is to reduce poverty. One of the effective ways. Second, as the economic development needs change, health service agencies should provide corresponding health services in time and prepare for the provision of services for new demands that may arise due to changes in demand; the government (health administration) should provide services. The perspective of the party controls the demand and inducement demand drawn from oversupply. Third, for the wealthy rural areas, the government provides only basic medical guarantees. The provision of other services is determined by the market. In terms of the protection system, the government should focus on establishing a risk-sharing mechanism rather than staying in basic medical services. Provide on. Fourth, in cities with chronic non-communicable diseases, the government can focus on promoting public health services in health policies and plans.