公众参与医疗服务质量改进:国际经验和中国展望

Public Participation in Medical Service Quality Improvement:International Experience and Chinese Perspective

目的探讨公众参与卫生服务质量管理的国际经验和中国发展前景。方法文献学习。结果公众参与卫生服务质量管理具有卫生服务民主化的政治意义,同时也是优化卫生服务管理、提高服务绩效和质量的途径之一。公众参与需要得到政府支持、消费者组织的影响力和资源、卫生行政管理的系统改革、对公众声音采取积极响应的承诺;公众参与的挑战来自政府决策证据和医学阶层及自律属性。同时公众界定、代表产生、参与方式等也是实际中面临的问题。公众参与的利益相关者互动过程和结果评价,是决定是否成功的因素。结论中国的公众参与还处于初级阶段,除依靠公民社会发展条件外,还需要完善适合中国特色的公众参与的科学证据。

Objective to explore international experience and Chinese perspective of public participation in health service quality management. Method literature review. Result public participation is a process of healthcare democratizing in political meaning and health service optimizing in management meaning. Public participation requests government support, power and resource of consumer organisation, health administration reformation and commitment on public voice. Challenges of public participation could be classified as government perception and evidence of effects on the initiative ; while identifying consumer, selection of representative, participation approach and specific aspect of involved health planning are also determinants of successful participation. Intervention among stakeholders and evidence of effect in Chinese and/or oriental environment are also considered as key factors of the participation. Conclusion China is in initial stage of public participation in given condition of premature development of civil society. Sophisticated researches are called especially conceptualisation, cultural and political contexts as evidence of developing guideline for Chinese public involvement in health care quality management.