我国区域整合型医疗健康服务体系的治理逻辑与路径分析——基于多中心治理视角

Analysis on the governance logic and path of regional integrated healthcare system in China: From the perspective of polycentric governance

治理机制是构建区域整合型医疗健康服务体系的核心机制之一,从单中心治理向多中心治理转变,是推动卫生健康领域治理体系与治理能力现代化的重要途径。本文基于多中心治理理论,探索构建区域整合型医疗健康服务体系多中心协同治理框架,提出多元主体协同治理结构以及实现制度有效嵌入的核心机制;针对实践中的现实困境,提出在构建区域整合型医疗健康服务体系过程中,要以健康为中心、以需求为导向明晰整合服务边界、构建适宜的整合策略,充分发挥多元主体的作用,健全治理机制、合理使用治理工具,推动形成网络化的多中心协同治理格局。

Governance mechanism is one of the core mechanism for building a regional integrated healthcare system. The transformation from single-center governance to polycentric governance is an important approach to promote the modernization of public health governance system and governance capacity. Based on polycentric governance theory, this paper tentatively built a polycentric synergetic governance framework for the regional integrated healthcare system, and proposed a polycentric synergetic governance structure and a core mechanism to achieve effective policy embedment. To address the realistic dilemmas in China, this paper proposed that in the process of building a regional integrated healthcare system, it is necessary to promote the formation of a networked, polycentric and synergetic governance structure by centering on health, clarifying the boundary of integrated healthcare using demand for orientation, developing appropriate integration strategies, making full use of multiple subjects, improving governance mechanisms and making proper use of governance tools.