公共卫生区域协同治理中的政策工具运用:多样性选择与多维性组合——来自中国五个区域的观察

Application of Policy Instruments in Regional Collaborative Governance of Public Health:Diversity Selection and Multidimensional Combination——Observations from Five Regions of China

要实现跨地区公共卫生治理的协同性,平战结合要求下政策工具多样选择和多维组合的挑战,地方政府的行动偏好和区域协同的整体结构是理论上重要议题。首先,文章结合政策工具的内在一致性和外在环境因素,综合选择政策工具储备、政策工具多样性和平战结合情况三个维度构建了包括八种理想模式的“工具箱”模型,来解释跨地区公共卫生治理中政策工具组合的运用。其次,选择了五个典型区域进行了比较分析,以说明三维“政策工具箱”所对应的若干政策工具组合模式的特征及其问题。研究发现:泛珠三角区域整体水平较高,平战结合、政策工具储备和多样性都较为理想,然而仍需在政策工具多样性方面进一步完善;京津冀地区和长三角地区的基础较为扎实,但分别在政策工具多样性和平战结合方面有改进余地;成渝地区和长江中游城市群的基础则相对较为薄弱,政策工具的储备情况均不理想,有进一步完善和提升的空间。最后,还对于当前跨地区公共卫生治理中的政策工具组合模式的总体特征和共性问题进行了讨论和分析。

Order to achieve the synergy of cross-regional public health governance,the challenge of diversified choices and multi-dimensional combination of policy instruments under the requirements of peacetime and wartime,the action preference of local governments and the overall structure of regional collaboration are important topics in theory.Firstly,combining the internal consistency of policy instruments and external environmental factors,this paper constructs a“Policy Toolkit”model including eight ideal types from three dimensions to measure the portfolio of policy instruments:reserve of policy instruments,diversity of policy instruments,and combination of peace and war,to explain the use of policy instrument combinations in regional public health governance.Secondly,five typical regions are selected for comparative analysis to illustrate the characteristics and problems of several policy instrument combination models corresponding to the three-dimensional“Policy Toolkit”.The results show that the overall level of the Pan-Pearl River Delta region is relatively high,and the combination of peacetime and wartime,reserve and diversity of policy instruments are ideal,but further improvement is still needed in policy diversification.The foundation of the Beijing-Tianjin-Hebei region and the Yangtze River Delta region is relatively solid,but there is room for improvement in the diversity of policy instruments and the combination of peace and war,respectively;The foundation of the Chengdu-Chongqing region and the Yangtze River midstream city cluster is relatively weak,and the reserve of policy instruments is not satisfactory,and there is room for further improvement.Finally,the paper discusses and analyzes the overall characteristics and common problems of the current model of portfolio of policy instruments in regional public health governance.