中国健康事业研究回顾与展望:献给建国七十周年

Review and prospect of health management research in China

党的十九大报告中指出,实施健康中国战略,要完善国民健康政策,为人民群众提供全方位全周期健康服务,这无疑把健康事业提到新的历史高度。我国健康事业从建国初期至今,已有70年。健康事业发展历程可分为初创时期、严重破坏时期、新的历史时期、新一轮医疗体制改革时期及健康事业发展热点与展望。每个时期,都具有鲜明特点。初创期,我国建立了"中西结合,预防为主"的卫生管理和工作方针,建立了以政府为主体向全体人民提供全部免费的医疗卫生服务为主要实践模式,建立了影响我国至今的医疗保障体制框架。严重破坏时期(1966-1976年),健康事业体系及其工作遭受严重的破坏,卫生防疫站及其他防疫防治机构被作为修正主义产物遭到批判否定、取消、合并。尽管如此,赤脚医生在这一特定历史阶段,发挥了实践促进合作医疗制度的作用。新的历史时期(1978-2004年),国家围绕卫生服务市场化、医疗保障制度、医院管理制度、医院管理人员职业化,突发公共卫生事件等重要问题进行了探讨与实践。新一轮医疗体制改革期(2005-2015年),国家对社区卫生服务、医疗费用控制、新农合等问题进行了实践与探讨。从2015起,我国健康事业研究热点主要集中在分级诊疗、家庭医生制的实施与完善、现代医院管理制度、医养结合、大数据背景下的健康产业发展等方向。

The report of the 19 th national congress of the communist party of China points out that the implementation of the healthy China strategy is to improve the national health policy, providing people with a full range of health services. It has been 70 years since the founding of the People’s Republic of China. The development process of health cause can be divided into five stages, namely, the start-up period, the period of severe damage, the new historical period, the period of new health reform and the future of health cause development. Each period has different characteristics. In the start-up period, China established the health policy of " Integrating Chinese and western medicine, focusing on prevention", and established the medical security system framework that has affected China so far. During the period of severe damage(1966-1976), the health service system suffered from serious damage, however, barefoot doctors played a practical role in promoting cooperative medical system at this particular stage in history. In the new historical period(1978-2004), the country carried out some important issues such as the marketization of health service, medical security system, hospital management system, professionalization of hospital management personnel, public health emergencies and so on. In the new round of health reform(2005-2015), the state has carried out practice and exploration on community health service, medical expense control, new rural cooperative medical system and other issues. From 2015, China mainly focuses on hierarchical diagnosis and treatment, the implementation family doctor system, modern hospital management system, and the development of health industry under the background of big data.