中国公共卫生综合监管体系、监管内容与工具的探讨
|
摘要
公共卫生综合监管制度建设是巩固和完善基本医疗卫生制度的重要内容,也是完善我国综合监管制度体系的重要手段。本文在分析公共卫生综合监管的目标以及所需遵循基本原则的基础上,探索设计我国公共卫生综合监管体系,进而探讨我国政府在公共卫生资源配置的公平性和有效性、突发紧急医疗救治和传染病防治方面的监管内容和监管工具的选择。监管内容主要包括关注公共卫生资源配置总量、结构和布局是否合理,有关机构在突发紧急情况下的人力、床位、设备等资源投入水平、处置数量和质量、专项经费使用情况以及政府、服务提供机构、患者、公众等各方满意度等,监管工具主要有公共卫生规划与资源配置计划、基于绩效的资源配置制度、公共卫生绩效评价和奖励制度、突发应急救治相关法规和制度等。最后,本文提出完善我国公共卫生综合监管体制机制的政策建议:加快加强法制建设,明确公共卫生监管主体并界定相应权限;合理分工,促进协同式监管体系的发展;多元共治,促进行业组织与社会监督作用的发挥。
The construction of a comprehensive public health regulatory system is an important content to consolidate and improve the basic medical and health system,and also an important opportunity to improve the comprehensive regulatory system in China. Based on the analysis of objectives and basic principles to be followed of the comprehensive regulation of public health,this paper explored to design a comprehensive regulatory system of public health in China. Furthermore,this article discussed governments' regulatory contents and selected tools in fields of fairness and effectiveness of public health resources allocation and emergency medical treatment and epidemic prevention. The regulatory contents were mainly consisted of whether an allocation of public health resource amount,structure and layout was reasonable or not,human,beds,equipment and other resources commitments of medical institutes in emergency treatments,the quantity and quality of emergency treatments,the use of special funds and the satisfaction of government,service providers,patients,public and other parties. Main regulatory tools concluded public health planning and resource allocation plan,resource allocation system based on performance,public health performance evaluation and incentive system,laws and systems for emergency treatment,etc. Finally,this paper put forward three policy suggestions to improve the mechanism of comprehensive regulatory system of public health in China:accelerating the construction of legal system to clarify the subjects of public health regulation and their corresponding authority; rational assignments of responsibilities to promote the development of a concordant regulatory system; multi-governing to promote the supervisory roles of industry organizations and the society.
The construction of a comprehensive public health regulatory system is an important content to consolidate and improve the basic medical and health system,and also an important opportunity to improve the comprehensive regulatory system in China. Based on the analysis of objectives and basic principles to be followed of the comprehensive regulation of public health,this paper explored to design a comprehensive regulatory system of public health in China. Furthermore,this article discussed governments' regulatory contents and selected tools in fields of fairness and effectiveness of public health resources allocation and emergency medical treatment and epidemic prevention. The regulatory contents were mainly consisted of whether an allocation of public health resource amount,structure and layout was reasonable or not,human,beds,equipment and other resources commitments of medical institutes in emergency treatments,the quantity and quality of emergency treatments,the use of special funds and the satisfaction of government,service providers,patients,public and other parties. Main regulatory tools concluded public health planning and resource allocation plan,resource allocation system based on performance,public health performance evaluation and incentive system,laws and systems for emergency treatment,etc. Finally,this paper put forward three policy suggestions to improve the mechanism of comprehensive regulatory system of public health in China:accelerating the construction of legal system to clarify the subjects of public health regulation and their corresponding authority; rational assignments of responsibilities to promote the development of a concordant regulatory system; multi-governing to promote the supervisory roles of industry organizations and the society.
引文
[1]中华人民共和国中央人民政府.全国卫生与健康大会19日至20日在京召开[EB/OL].(2016-08-20)[2017-09-25]. http://www. gov. cn/xinwen/2016-08/20/content_5101024. htm.
[2]郭晓薇,连漪.综合监管之路变则通[J].中国卫生,2017(7):57-59.
[3]陈莉,樊立华.调整、完善我国公共卫生监管体制的刍议与探讨[J].中国卫生事业管理,2005(3):159-160.
[4]邱五七,毛阿燕,严晓玲,等.从H7N9禽流感事件看我国公共卫生应急防控及监管[J].中国公共卫生管理,2016,32(3):330-333.
[5]李滔,王秀峰.健康中国的内涵与实现路径[J].卫生经济研究,2016(1):4-10.
[6]王虎峰.健康到底是什么层面的问题[J].中国卫生,2016(2):7.
[7]吕筠,李立明.现代公共卫生体系的基本职能及其内涵[J].中国公共卫生,2007,23(8):1022-1024.
[8]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,2017,29(10):750-753,774.
[9]国务院办公厅.全国医疗卫生服务体系规划纲要(2015-2020)[EB/OL].(2015-03-30)[2017-09-25]. http://www. gov. cn/zhengce/content/2015-03/30/content_9560. htm.
[10]邓峰,高建民,吕菊红.公共卫生管理的新视角:协作性公共管理[J].中国卫生质量管理,2014,21(1):115-118.
[11]孙梅,陈文,王汉松.我国食品等公共卫生监管体系存在的问题及其对策[J].中国卫生政策研究,2008,1(2):18-20.
[2]郭晓薇,连漪.综合监管之路变则通[J].中国卫生,2017(7):57-59.
[3]陈莉,樊立华.调整、完善我国公共卫生监管体制的刍议与探讨[J].中国卫生事业管理,2005(3):159-160.
[4]邱五七,毛阿燕,严晓玲,等.从H7N9禽流感事件看我国公共卫生应急防控及监管[J].中国公共卫生管理,2016,32(3):330-333.
[5]李滔,王秀峰.健康中国的内涵与实现路径[J].卫生经济研究,2016(1):4-10.
[6]王虎峰.健康到底是什么层面的问题[J].中国卫生,2016(2):7.
[7]吕筠,李立明.现代公共卫生体系的基本职能及其内涵[J].中国公共卫生,2007,23(8):1022-1024.
[8]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,2017,29(10):750-753,774.
[9]国务院办公厅.全国医疗卫生服务体系规划纲要(2015-2020)[EB/OL].(2015-03-30)[2017-09-25]. http://www. gov. cn/zhengce/content/2015-03/30/content_9560. htm.
[10]邓峰,高建民,吕菊红.公共卫生管理的新视角:协作性公共管理[J].中国卫生质量管理,2014,21(1):115-118.
[11]孙梅,陈文,王汉松.我国食品等公共卫生监管体系存在的问题及其对策[J].中国卫生政策研究,2008,1(2):18-20.