基本医疗服务的界定思路和框架

Thoughts and framework on how to define essential medical services

利用优先选择法和综合平衡法对卫生服务需求、供给和筹资数据进行分析，认为我国的基本医疗服务包应体现中国特色，与党的执政理念和社会核心价值观相一致，充分考虑中国的管理体制、执政理念、医疗保险制度以及政府在卫生事业发展中的责任等，从多维度进行界定，突出重点健康问题，并与我国当前的医药卫生体制改革进程相适应。基本医疗服务的界定需要考虑供给、需求和筹资3个维度，并应注重房屋、设备、人员、技术、耗材和药品等医疗服务要素的影响。由此提出了由基本医疗服务基层包、核心包、优先包和扩展包等4个层次服务包组成的我国基本医疗服务总体框架。

Boundaries definition plays a key role in defining the scope of essential medical coverage of the country and the governmental role positioning in medical service offerings. It is also a precondition of furthering the ongoing healthcare reform. This paper analyzed the data of health service demand, supply and financing using the priority setting and the integrated balance methods. It suggested that the definition of the essential medical services should embody Chinese characteristics and be consistent with the Party＇s governing philosophy and social core values. It also should be fully considered that the administration system, the governing philosophy, the medical insurance system and the government duty in the healthcare system of China. This paper proposed a multiple-criteria defining of the essential medical services, which should focus on main healtheare issues in China, and be adapted to the current healthcare reform process. Three dimensions need to be considered in the defining,which are the demand, supply and financing of the healtheare services, along with the impact of the housing, equipment, personnel, technology, supplies, drugs and other medical service elements. This paper presented the overall framework of essential medical services in four levels, which is composed of the basic package, the core package, the priority package and the expansion package.