公共治理视角下的“子长医改”

Medical Reform under the Public Governance Perspective in Zichang County

文章基于2012年国家卫生部牵头、西安交通大学公管学院负责的子长县公立医院改革(以下简称子长医改)阶段性评估项目所搜集的数据,利用公共治理分析框架,从治理目标、治理理念、治理结构、治理机制、治理工具、治理效率6个方面分析子长医改的过程及效果。分析发现,子长医改治理主体重视为民服务的治理理念,子长医改基本达到解决"看病贵"的治理目标,以"人民得实惠、医务人员受鼓舞"为判定标准的治理效果也很明显,同时也建立了一整套比较成熟的治理机制。但其治理结构还比较简单,治理工具缺乏长期有效性。在此分析基础上,本文为子长医改提出一些可借鉴的意见。

Based on t he data collected from the periodic assessment project about the reform in public hospitals of Zichang County which led by the Ministry of Health and the Public and Administration of Xi＇an Jiaotong University, using the public governance analysis framework to analyze the process and effect of health care reform in Zichang County from perspective of governance goal, governance concept, governance structure, governance mechanisms, governance tools and governance performance. Through the analysis, it is found that governance body of Zichang County＇s health care reform has the concept of serving the public, the refnnn achieved its governance goal of ＂expensive to visit the doctor＂, the governance perfnrnmnce determined by ＂the people benefited, medical staff encouraged＂ was also evident, and a set of more mature governance mechanisms was established as well. But its governance strueture is still relative simple and its governance tools lack of long-term effectiveness. Based on the analysis, suggestions are given for the health care reform of Ziehang County.