我国公共卫生体系建设发展历程、现状、问题与策略
|
摘要
新中国建国近70年,我国公共卫生事业取得了显著的成绩,但也面临很多问题与挑战,现阶段我国公共卫生体系发展滞后于经济和其他社会事业发展,本文对我国公共卫生体系发展历程、现状与问题进行分析和研究,我国公共卫生体系存在的主要问题包括:公共卫生体系发展滞后、缺乏顶层设计,重治轻防的思想观念阻碍公共卫生体系建设,财政投入总量、结构及方式不适应公共卫生体系发展需要,公共卫生人才队伍不稳定、发展乏力,公共卫生信息化整体滞后、投入及人才缺口较大,法制建设不完善、行政赋权缺失。在此基础上提出建立完善新时代公共卫生服务体系的策略建议,构建医防结合的卫生服务体系,优化财政投入模式、建立多渠道筹资机制,加强公共卫生体系人才队伍建设,完善公共卫生信息化建设,完善公共卫生法律体系等。
In the past 70 years since the founding of the People's Republic of China, China has made remarkable achievements but also faces many problems and challenges in public health. At present, the development of public health service system in China lags behind the that of economy and other social undertakings. In the study, we analyzed and studied the development process and problems of public health system in China. The main problems in China's public health system include: the lagged development of the public health system, the lack of top-level design, the widening gap between the medical system and the public health system, the inadequacy of the total amount/structure and mode of financial investment in the development of the public health system, the instability and weak development of public health personnel, and laggingbehind public health informatization, obvious shortages in investment and talent resources, imperfect legal system construction, and the lack of administrative empowerment. To those problems mentioned above, the study puts forward some suggestions for improving the public health service system in the new era, such as building a health service system combining medicine with prevention, optimizing the mode of financial investment, establishing a multi-channel financing mechanism,strengthening the construction of talents in public health system, improving the construction of public health informatization,and improving the public health legal system.
In the past 70 years since the founding of the People's Republic of China, China has made remarkable achievements but also faces many problems and challenges in public health. At present, the development of public health service system in China lags behind the that of economy and other social undertakings. In the study, we analyzed and studied the development process and problems of public health system in China. The main problems in China's public health system include: the lagged development of the public health system, the lack of top-level design, the widening gap between the medical system and the public health system, the inadequacy of the total amount/structure and mode of financial investment in the development of the public health system, the instability and weak development of public health personnel, and laggingbehind public health informatization, obvious shortages in investment and talent resources, imperfect legal system construction, and the lack of administrative empowerment. To those problems mentioned above, the study puts forward some suggestions for improving the public health service system in the new era, such as building a health service system combining medicine with prevention, optimizing the mode of financial investment, establishing a multi-channel financing mechanism,strengthening the construction of talents in public health system, improving the construction of public health informatization,and improving the public health legal system.
引文
[1]李斌.实施健康中国战略[N].人民日报,2018-1-12.
[2]习近平:把人民健康放在优先发展战略地位[EB/OL].新华网,http://www.xinhuanet.com//politics/2016-08/20/c_1119425802.htm.
[3]傅华.以“大卫生大健康观”来建设现代公共卫生体系[J].上海预防医学,2017,10(29):750-753.
[4]李立明.新中国公共卫生60年的思考[J].中国公共卫生管理,2014,30(3):311-315.
[5]楚安娜,许迎喜,吕全军,等.中国公共卫生体系建设面临的挑战与对策[J].中国初级卫生保健,2013,27(12):1-4.
[6]中共中央国务院关于深化医药卫生体制改革的意见[EB/OL].中国政府网,http://www.gov.cn/test/2009-04/08/content_1280069.htm
[7]2017年我国卫生健康事业发展统计公报[EB/OL].国家卫生计生委.http://www.nhfpc.gov.cn/guihuaxxs/s10743/201806/44e3cd fe11fa4c7f928c879d435b6a18.shtml
[8]于贞杰.公共卫生体系研究--功能、资源投入和交易成本[M].北京:经济科学出版社.2009.
[9]李立明,姜庆五.中国公共卫生理论与实践[M].北京:人民卫生出版社.2015.
[10]石东风,万兵华,叶琳,等.构建我国公共卫生法律体系框架的探讨[J].中国公共卫生,2014,20(1):80-81.
[11]国家卫生健康委员会.中国卫生健康统计年鉴(2018)[M].北京:中国协和医科大学出版社.2018.
[12]郭峰,万泉,张毓辉.基于“卫生费用核算体系2011”的中国预防费用核算结果[J].中国卫生经济,2015,34(3):20-22.
[13]郭晓斐,赵平,高翠巧.政府购买公共卫生服务与中国癌症基金会的发展[J].中国肿瘤,2018,27(9):656-659.
[14]王居一.公共卫生管理中的问题与应对措施分析[J].经济研究导刊,2017(5):169-170.
[15]国家卫生计生委.2015年中国居民营养与慢性病状况报告[R].北京,2015.
[16]韩建华,高永海,蔡恩昌,等.我国慢性病防治策略现状与思考[J].中国健康教育,2014,30(12):1118-1120.
[17]郝模,李程跃,于明珠,等.新时代公共卫生体系的思考与研究[J].上海预防医学,2017,29(12):905-910.
[18]雷海潮,黄家玮,侯建林,等.对中国公共卫生体制建设和有关改革的反思与建议[R].中国发展评论,7(增刊1期):47-62.
[19]王陇德.弥合临床医学与公共卫生的裂痕提高卫生工作的效能与效益[J].中国预防医学杂志,2010,11(1):3-4.
[20]徐建国,刘开泰,陈博文,等.建立新型国家预防医学体系战略研究[J].中国工程科学,2017,19(2):55-61.
[21]韩柏慧,王兆南,张金艳,等.北京市朝阳区社区公共卫生服务人力现状分析[J].中国卫生资源,2016,19(4):335-339.
[22]朱杰,丁翀.苏州市公共卫生信息化存在的问题及解决方式[J].中国科技信息,2016,19:23-24.
[23]Committee for the Study of the Future of Public Health,Institute of Medicine.The future of public health[R].Washington D.C.:National Academy Press,1988.
[24]U.S.Department of Health and Human Services.Public health in America[R].Washington D.C.:U.S.Department of Health and Human Services,1994.
[25]金成波.美国联邦公共卫生规制体系及其对我国的启示[J].中国行政管理,2016(7).
[26]Turnock BJ,Handler AS.From measuring to improving public health practice[J].Annu Rev Public Health,1997,18:261-282.
[27]CDC.National Public Health Performance Standards[EB/OL].[2011-11-28].https://www.cdc.gov/stltpublichealth/nphps/index.html.
[28]王璟.发达国家公共卫生体系特点及对我国公共卫生体系改革的启示[J].医学与社会,2005(07):25-26.
[29]Podger A,Hngan P.Reforming the Australian health care system:the role of government[M]//Bloom AL.Health reform in Australia and New Zealand.Melbourne:Oxford University Press,2000.
[30]Weffare HJ.Options:delivering social services[M].Sydney:Allen and Unwin,1998.
[31]赵茜.对我国与公共卫生事业相分离的医疗保险制度的反思[J].社会工作,2006(12):56-58.
[32]龚向光.加大公共卫生投入改革公共卫生筹资体制[J].中国卫生经济,2003,22(12):13-15.
[33]王祺.新形势下加大公共卫生财政投入的重要性及对策分析[J].经济师,2018,5:226-227.
[2]习近平:把人民健康放在优先发展战略地位[EB/OL].新华网,http://www.xinhuanet.com//politics/2016-08/20/c_1119425802.htm.
[3]傅华.以“大卫生大健康观”来建设现代公共卫生体系[J].上海预防医学,2017,10(29):750-753.
[4]李立明.新中国公共卫生60年的思考[J].中国公共卫生管理,2014,30(3):311-315.
[5]楚安娜,许迎喜,吕全军,等.中国公共卫生体系建设面临的挑战与对策[J].中国初级卫生保健,2013,27(12):1-4.
[6]中共中央国务院关于深化医药卫生体制改革的意见[EB/OL].中国政府网,http://www.gov.cn/test/2009-04/08/content_1280069.htm
[7]2017年我国卫生健康事业发展统计公报[EB/OL].国家卫生计生委.http://www.nhfpc.gov.cn/guihuaxxs/s10743/201806/44e3cd fe11fa4c7f928c879d435b6a18.shtml
[8]于贞杰.公共卫生体系研究--功能、资源投入和交易成本[M].北京:经济科学出版社.2009.
[9]李立明,姜庆五.中国公共卫生理论与实践[M].北京:人民卫生出版社.2015.
[10]石东风,万兵华,叶琳,等.构建我国公共卫生法律体系框架的探讨[J].中国公共卫生,2014,20(1):80-81.
[11]国家卫生健康委员会.中国卫生健康统计年鉴(2018)[M].北京:中国协和医科大学出版社.2018.
[12]郭峰,万泉,张毓辉.基于“卫生费用核算体系2011”的中国预防费用核算结果[J].中国卫生经济,2015,34(3):20-22.
[13]郭晓斐,赵平,高翠巧.政府购买公共卫生服务与中国癌症基金会的发展[J].中国肿瘤,2018,27(9):656-659.
[14]王居一.公共卫生管理中的问题与应对措施分析[J].经济研究导刊,2017(5):169-170.
[15]国家卫生计生委.2015年中国居民营养与慢性病状况报告[R].北京,2015.
[16]韩建华,高永海,蔡恩昌,等.我国慢性病防治策略现状与思考[J].中国健康教育,2014,30(12):1118-1120.
[17]郝模,李程跃,于明珠,等.新时代公共卫生体系的思考与研究[J].上海预防医学,2017,29(12):905-910.
[18]雷海潮,黄家玮,侯建林,等.对中国公共卫生体制建设和有关改革的反思与建议[R].中国发展评论,7(增刊1期):47-62.
[19]王陇德.弥合临床医学与公共卫生的裂痕提高卫生工作的效能与效益[J].中国预防医学杂志,2010,11(1):3-4.
[20]徐建国,刘开泰,陈博文,等.建立新型国家预防医学体系战略研究[J].中国工程科学,2017,19(2):55-61.
[21]韩柏慧,王兆南,张金艳,等.北京市朝阳区社区公共卫生服务人力现状分析[J].中国卫生资源,2016,19(4):335-339.
[22]朱杰,丁翀.苏州市公共卫生信息化存在的问题及解决方式[J].中国科技信息,2016,19:23-24.
[23]Committee for the Study of the Future of Public Health,Institute of Medicine.The future of public health[R].Washington D.C.:National Academy Press,1988.
[24]U.S.Department of Health and Human Services.Public health in America[R].Washington D.C.:U.S.Department of Health and Human Services,1994.
[25]金成波.美国联邦公共卫生规制体系及其对我国的启示[J].中国行政管理,2016(7).
[26]Turnock BJ,Handler AS.From measuring to improving public health practice[J].Annu Rev Public Health,1997,18:261-282.
[27]CDC.National Public Health Performance Standards[EB/OL].[2011-11-28].https://www.cdc.gov/stltpublichealth/nphps/index.html.
[28]王璟.发达国家公共卫生体系特点及对我国公共卫生体系改革的启示[J].医学与社会,2005(07):25-26.
[29]Podger A,Hngan P.Reforming the Australian health care system:the role of government[M]//Bloom AL.Health reform in Australia and New Zealand.Melbourne:Oxford University Press,2000.
[30]Weffare HJ.Options:delivering social services[M].Sydney:Allen and Unwin,1998.
[31]赵茜.对我国与公共卫生事业相分离的医疗保险制度的反思[J].社会工作,2006(12):56-58.
[32]龚向光.加大公共卫生投入改革公共卫生筹资体制[J].中国卫生经济,2003,22(12):13-15.
[33]王祺.新形势下加大公共卫生财政投入的重要性及对策分析[J].经济师,2018,5:226-227.