公共部门战略管理视域下的医保战略购买:解释框架与中国内涵

Strategic purchase of health insurance from the perspective of strategic management in public sectors:An interpretive framework and its Chinese connotation

发挥医保战略性购买作用是深化医疗保障改革的重要内容,但有关战略购买的理论研究还相对滞后,本文在已有研究基础上,运用公共部门战略管理理论,建构了一个包括战略购买使命、战略购买规划、战略购买实施和战略购买评估四大阶段在内的医保战略购买解释框架。在此基础上,结合中国情境并运用解释框架详细分析了医保战略购买的中国内涵。认为中国医保战略购买要以满足人民健康需求为使命,系统考虑内外环境和作用领域,科学分析战略购买的五个环节并强化购买支撑,构建基于使命导向的多元主体参与评估机制,最终破除制约人民健康需求满足的体制、机制障碍。

Playing the strategic role of health insurance purchase is a crucial part of deepening the reform of the medical security system.However,theoretical research on strategic purchase lags far behind.Based on existing research and the theory of strategic management in public sectors,this paper constructs an interpretive framework for strategic purchase of health insurance,which consists of four major stages:mission,planning,implementation,and evaluation.Then,combined with the context of strategic purchase of health insurance in China,the interpretive framework is used to analyze in detail the Chinese implications of strategic purchase.It is believed that strategic purchase of China s health insurance should aim to meet the health needs of the people,systematically consider the internal and external environments and fields of action,scientifically analyze the five links of strategic purchase and strengthen purchase support,establish a mission-oriented evaluation mechanism involving multiple stakeholders,and ultimately remove institutional and mechanistic obstacles that constrain the satisfaction of people s health needs.