政府在医疗服务中的责任——古巴的经验和启示

Government's Responsibilities in Health Provision: Experience from Cuba

古巴作为发展中国家中的大国,其医疗体系改革取得了较好的成就。本文论述了古巴医疗改革的成就与特点,总结了其医疗体系建设的经验,如有国家制度保障和财政全力支持,采取多种方式降低医疗费用以及重点关怀妇婴与老人。同时也分析了这种医疗体系中存在的问题,如计划体制下向医疗过度配置资源,对医生激励不够等。在此基础上,本文提出中国应借鉴古巴经验,加强初级医疗网建设,明确政府责任的界限与方式,加强医药卫生人才队伍建设,利用信息化手段保障社区医疗机构良性运转。

As a large developing country, Cuba has made notable achievements in its medical care system reform.This paper introduces Cuba's progresses and features of its medical care reform, and summarizes its experience of medical care system construction, such as firm national institutional guarantee, full fiscal support,lowering medical costs through various means, and focusing on infants, women and the elderly. Meanwhile,this paper also analyses problems of Cuba's medical care system, for example, excessive allocation of resources due to planning system, and insufficient incentives to doctors. Based on above analysis, this paper advises that China should drawlessons from Cuba's experience, strengthen construction of primary medical care system, clear boundaries and ways of government responsibilities, enhance health team building, and applyinformation technologies toensure good operation ofcommunitymedical institutions.