中部欠发达县域社会办医的协同治理效果评价——以湖北省麻城市为例
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摘要
构建中部欠发达县域社会办医协同治理效果评价指标体系,运用湖北省麻城市的实地调研数据,从协同治理主体参与度、客体发展度、机制完善度、对象满意度四个方面测度分析了中部欠发达县域社会办医协同治理的效果及其成因。结果表明:①中部欠发达县域社会办医协同治理主体参与程度低,医疗纠纷处理效率有待提高;②中部欠发达县域社会办医机构自身发展不成熟,专业性低,工作人员缺乏规范化培训,软实力与硬实力都不具备与公立医院抗衡的条件;③中部欠发达县域对第三方机制的重视程度不高,在实际协同治理过程中没有发挥出第三方机制的作用;④中部欠发达县域公众即社会办医协同治理对象需提高医疗文化素养,缩小医疗信息不对称的差距。研究认为,中部欠发达县域应优化社会办医协同治理路径,着力健全基层医疗卫生服务体系,加快服务能力现代化建设。
Based on the fieldwork data of Macheng County in Hubei Province, this paper constructs an evaluation index system for the effect of collaborative governance of private medical institutions in underdeveloped counties of central China and analyses the effect and the cause of the collaborative governance of private medical institutions in underdeveloped counties of central China, from the four aspects of collaborative governance's subject participation degree, object development degree, mechanism perfection degree, and object satisfaction degree. The results show that: 1)the subject participation of collaborative governance in underdeveloped counties of central China is in the low level, the treatment efficiency of medical disputes remains to be improved; 2) private medical institutions in underdeveloped counties of central China which are at an immature stage and lack of professional and standardized training, can't compete with public hospitals from the perspectives of soft power and hard power; 3) the underdeveloped counties of central China pay no enough attention to the third-party mechanism, and do not play the role of third-party mechanism in the process of collaborative governance; 4) It should improve the public's medical literacy level and reduce the gap of medical information asymmetry in underdeveloped counties of central China. It's found that it should optimize the collaborative governance path of private medical institutions, focus on improving the system of basic health services and accelerate the modernization of the service capacity in the underdeveloped counties of central China.
Based on the fieldwork data of Macheng County in Hubei Province, this paper constructs an evaluation index system for the effect of collaborative governance of private medical institutions in underdeveloped counties of central China and analyses the effect and the cause of the collaborative governance of private medical institutions in underdeveloped counties of central China, from the four aspects of collaborative governance's subject participation degree, object development degree, mechanism perfection degree, and object satisfaction degree. The results show that: 1)the subject participation of collaborative governance in underdeveloped counties of central China is in the low level, the treatment efficiency of medical disputes remains to be improved; 2) private medical institutions in underdeveloped counties of central China which are at an immature stage and lack of professional and standardized training, can't compete with public hospitals from the perspectives of soft power and hard power; 3) the underdeveloped counties of central China pay no enough attention to the third-party mechanism, and do not play the role of third-party mechanism in the process of collaborative governance; 4) It should improve the public's medical literacy level and reduce the gap of medical information asymmetry in underdeveloped counties of central China. It's found that it should optimize the collaborative governance path of private medical institutions, focus on improving the system of basic health services and accelerate the modernization of the service capacity in the underdeveloped counties of central China.
引文
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[2]周小园.我国社会办医的发展现状及扶持策略研究[D].济南:山东大学,2015.
[3]周定财.基层社会管理创新中的协同治理研究[D].苏州:苏州大学,2017.
[4]杨华锋,杨蕾.国内协同治理研究现状与展望[J].社会治理,2016(5):63-72.
[5]彭耿,刘芳.武陵山片区区域经济协同度的评价研究[J].经济地理,2014,34(10):39-45.
[6]王志民.江苏省区域旅游产业与科技创新协同度研究[J].世界地理研究,2016,25(6):158-165.
[7]燕继荣.协同治理:社会管理创新之道——基于国家与社会关系的理论思考[J].中国行政管理,2013(2):58-61.
[8]罗志刚.中国城乡社会协同治理的逻辑进路[J].江汉论坛,2018(2):74-79.
[9]张仲涛,周蓉.我国协同治理理论研究现状与展望[J].社会治理,2016(3):48-53.
[10]吴笑,魏奇锋,顾新.协同创新的协同度测度研究[J].软科学,2015,29(7):45-50.
[11]马历,龙花楼,戈大专,等.中国农区城乡协同发展与乡村振兴途径[J].经济地理,2018,38(4):37-44.
[12]聂法良.城市森林协同治理体系的协同度评价指标及应用——以青岛市为例[J].山东农业大学学报:自然科学版,2015,46(2):173-179.
[13]武玉英,魏国丹,何喜军.基于耦合系数模型的高技术制造业与要素协同度测度及实证[J].系统工程,2017,35(7):93-100.
[14]刘伟忠.我国地方政府协同治理研究[D].济南:山东大学,2012.
[15]金嘉杰,董丽佳,钱稳吉,等.政府鼓励和引导政策下中国社会资本办医的发展状况[J].中国卫生政策研究,2017,10(9):68-74.
[16]于江,魏崇辉.多元主体协同治理:国家治理现代化之逻辑理路[J].求实,2015(4):63-69.
[17]农圣,黄二丹,江蒙喜.协同医疗服务体系的构建机制分析[J].中国卫生经济,2017,36(7):13-16.
[18]王碧艳.县域医疗服务体系多元组织协同机制研究[D].武汉:华中科技大学,2013.
[19]王有强,李海明,王文娟.卫生体系和服务能力现代化的实现路径:基于协同治理视角[J].中国行政管理,2017(4):35-39.
[20]姚翼源,张诚.基层社会协同治理机制与路径研究——以合肥市蜀山区为例[J].当代经济管理,2017,39(8):27-32.
[21]赵秀玲.中国基层协同治理的路径选择[J].新视野,2016(2):57-66.
[22]张雷,傅涵,李月娥.基于协同治理的基层医疗服务能力提升研究——以沈阳市为例[J].党政干部学刊,2017(8):42-49.
[23]叶林,张光明.城乡基层协同治理的难题与化解:顺德改革的探索[J].公共行政评论,2014,7(2):23-44,170-171.