宁波市江北区社区卫生服务综合配套改革的政策评价

The public policy analysis and evaluation on comprehensive reform of community health services in Jiangbei District Ningbo City

自上而下的行政命令式的改革是当前社区卫生服务改革的主要方式,其显著的特征就是通过一系列政策的制定来构建新的运行体制。本文从公共政策的制度效益和政策目标效益对宁波江北区的社区卫生服务综合改革做了客观的评价。制度方面,江北区探索建立了"三位一体"的社区卫生服务公益性机制,构建了以全科团队为核心的服务模式,完善了服务的网络体系,强化了公共卫生服务。政策效益方面,社区卫生服务费用下降,利用率提高,质量和效率得到强化,公益性与可及性得到改善,改革初步形成了"同利"机制,综合配套改革的满意度较高。未来改革中,社区卫生服务全科医生人才培养和绩效评价指标改革方面还有待于进一步加强。

The reform from top to bottom by administrative order is a major mode in reforming community health service currently. Its remarkable features are to build a new operating system through a series of policy-making intervention. This article conducts an objective evaluation in accordance with the public policy behavior efficiency and objectives effectiveness about Jiangbei＇s comprehensive reform of community health services. From a system perspec- tive, Jiangbei District has explored to built a trinity community health services public welfare system, which estab- lished a general service model as the core team, improved service network system, and strengthened public health services. From policy effective perspective, the fee of community health services decreased, service utilization is im- proved, the quality and efficiency are enhanced, and the public interest and accessibility are improved. The reform formed a ＂with profits＂ system at the first stage, the satisfaction of the comprehensive reform is higher. The article recommends that the training of general practitioners and performance evaluation indicators need to be further strengthened in future community health services reform.