系统论视角下健康扶贫长效机制的构建——基于制度层面的分析

The Construction of long-term mechanism of health poverty alleviation from the perspective of system theory——Based on the Analysis of institutional level

健康扶贫是在精准扶贫的基础上,针对"因病致贫""因病返贫"的问题突出而制定的扶贫政策。本文在系统论的视角下分析健康扶贫内涵及制度层面的实施困境,发现各地健康扶贫政策在制定和实施过程中存在政策目标理念偏差,且政策间缺乏协调和耦合,着重于"输血式"扶贫,返贫现象突出,缺少动态监管和考核机制等问题,依据系统论的整体性和联系性、层次结构性、动态平衡性和时序性的原则构建健康扶贫的长效机制,必须做好顶层设计,实现"科学扶贫",加强政策的有效衔接和耦合,形成政策合力,促进基本卫生服务和公共卫生服务的建设,完善健康扶贫的动态管理和考核机制,以期全面、科学、持久地提高贫困人口的健康水平,完成"输血式"健康扶贫向"造血式"的转变,推进健康中国的建设。

Health poverty alleviation is a poverty alleviation policy formulated on the basis of precision poverty alleviation,aiming at the problem of＂due to poverty due to illness＂and＂return poverty due to illness＂. This article analyzes the connotation of health poverty alleviation and the implementation dilemma at the perspective of system theory. There are deviations in policy objectives in the process of formulation and implementation of health poverty alleviation policies,and there is a lack of coordination and coupling between policies,focusing on＂transfusional＂poverty alleviation. The problem of returning to poverty is prominent,and there is a lack of dynamic monitoring and assessment mechanisms.Based on the principles of integrity and connectivity of systems theory,principles of hierarchical structure,dynamic balance,and timeliness,a long-term mechanism for poverty alleviation in health must be constructed. Top-level design must be implemented. ＂Science for Poverty Alleviation＂strengthens the effective convergence and coupling of policies,forms a policy joint force,promotes the construction of basic health services and public health services,and perfects the dynamic management and assessment mechanism for health-related poverty alleviation,with a view to improving the health of the poor comprehensively,scientifically,and permanently. At the same level,we will complete the transformation of＂transfusion-style＂poverty alleviation to＂hematopoietic＂and advance the construction of healthy China.