卫生服务购买:国际经验与中国实践

The purchase of health services:international experience and China's practice

从国际卫生服务购买的发展进程来看,由于各国卫生服务体制的不同,购买者组织的结构与模式呈现出多样性的特点,采取和实施战略性购买的改革措施与进程并不一致,同时面临着购买技术、成本以及合同管理等问题。比较国际经验,在我国目前实施的卫生服务购买中,存在购买者竞争、财政投入不均、基本服务包界定标准不一以及合同管理、绩效评估等方面的缺失与不足,制约了卫生系统绩效的有效改善。要实现真正意义上的综合整体购买,需要在政府角色、管理体制、市场环境、购买技术等方面搭建一个政府购买卫生服务行动的支持平台。

The purchase of health services from the international development process, due to the different healthservice systems, makes the Buyers＇ structure and mode of organization vary in the characteristics. The adoption and implementation of strategic purchases of reform measures and process is inconsistent, faced with such problems aspurchase of technology, cost, and contract management. Compared with international purchase, China is faced with the lack of buyers competition, measured cost and a basic package of services, diversification of supply, contractmanagement, performance assessment ,which is bound to improve performance of health systems. To realize the true sense of the overall and comprehensive purchasing, it is necessary to build a government purchase of health services operations support platform through the role of government, management system, market conditions, purchase oftechnology.