重返社会的医疗:联动型慈善医疗救助的实践机制研究——以S市儿童医院为例

Reintegration of Social Medical Care:A Study on the Practice Mechanism of Linkage-Type Synergy in Charitable Medical Assistance—Taking S Children’s Hospital as an Example

目前医学人本主义精神及生命主体性认同面临着严峻挑战。在我国卫生治理的语境下,社会经济因素被视为疾病的主要根源,贫困人群的人文关怀等议题成为反思社会医学化实践的驱动力。如何回应慈善医疗救助的需求变化,使医疗回归社会,成为本文关注的核心命题。本文借助波兰尼嵌入性的理论视角,依托医学脱嵌于社会的现实背景,结合“嵌入-嵌合”的分析框架,通过对S市儿童医院慈善医疗救助的经验研究,试图揭示慈善医疗救助的深层逻辑及联动运行机制。研究发现,联动型协作作为医疗社会化实践中嵌合共生有机体的核心,通过多元主体联动协同参与慈善医疗救助,强化了以人为中心救助的社会效能,形成了以政策为导向的激励机制、以社会需求为导向的动力机制,并经由整体性思维重塑以价值理念和效益为本的嵌合共生的行动机制。慈善医疗救助进一步助推了国家卫生治理的良性运行,提升了医疗服务的治理效能,并为贫困人群恢复健康、重建社会生活的医疗救助事业发展提供了经验性的路径指引。

The spirit of medical humanism and the identity of life subjectivity are currently facing serious challenges.In the context of health governance in China,socio-economic factors are regarded as the main root causes of disease,and topics such as humanistic care for the poor have become the driving force for reflecting on the practice of social medicalisation.How to respond to the changing needs of charitable medical assistance and return medical care to society has become the core proposition of this paper’s concern.With the help of Polanyi’s theoretical perspective of embeddedness,relying on the reality of medicine being embedded in society,and combining the analytical framework of“embeddedness-embeddedness”,this paper attempts to reveal the deep logic and linkage mechanism of charitable medical aid through the empirical study of S Children’s Hospital’s charitable medical aid.The study finds that,as the core of the embedded symbiosis organism in medical socialisation practice,the linkage collaboration strengthens the social efficacy of people-centred assistance through the joint participation of multiple actors in charitable medical assistance,forms a policy-oriented incentive mechanism and a social demand-oriented motivation mechanism,and reshapes the embedded symbiosis mechanism based on the concept of value and effectiveness through holistic thinking.Charitable medical assistance has further promoted the sound operation of national health governance,enhanced the governance effectiveness of medical services,and provided empirical guidance for the development of medical assistance in restoring the health of the poor and rebuilding their social life.