紧密型县域医共体政府监管的问题探析和对策研究

Problems and solutions of medical alliances regulatory:an analysis based on the Smith model

紧密型县域医共体(简称紧密型医共体)是我国现阶段进一步深化医药卫生体制改革、落实分级诊疗制度的重要路径和关键举措。文章基于紧密型医共体的监管现状,以史密斯模型理论为框架,从政策目标、执行机构、目标群体和外部环境四个方面对紧密型医共体的监管困境及问题进行剖析。结果显示,政策目标模糊、执行机构协调性不足、经济与技术环境作用有限等因素一定程度上影响了紧密型医共体监管效果。针对存在问题,应完善监管政策体系、明确执行主体权责、促进目标群体参与、优化社会技术环境来推动紧密型医共体的高质量发展。

Medical alliances was the important path and key implement of the reform of medical and health system and hierarchical medical system at present in China.Based on the current status of regulatory implementation,this study used the Smith model as a framework to analyze the implementation of medical alliances regulatory policy from four aspects:policy itself,policy implementation subject,and policy implementation object and policy execution environment.The results showed that fuzzy policy objectives,insufficient coordination of implementing subject and limited economic and technological environment influence regulatory effect.It is necessary to improve the regulatory policy system,clarify the rights and responsibilities of the subject,promote the participation of objectives,and optimize the social and technological environment to promote the high-quality development of the medical alliances.