摘要
西藏自治区各级地方政府借助中央政府和外省市的转移资源,坚持不懈地投资于人民健康,一方面通过财政支出维护农牧区的3级卫生服务网络,另一方面,运用政策干预手段推行针对健康高风险群体的保健项目。这不仅为全自治区人口健康指标的改善作出贡献,而且为其他省/区在经济市场化进程中强化公共健康安全提供了值得借鉴的经验。然而在农牧区人口居住分散、交通不便和卫生机构服务能力薄弱的情况下,基层卫生服务的供给还远未满足农牧人口对服务便捷性、及时性和可靠性的要求。目前的出路在于,第一,改善卫生机构管理,提高公共卫生机构的业务水平和流动服务能力。第二,在有限开放医疗市场的基础上,通过资格认定和报销规定等制度安排,将个体乡村医生的服务纳入合作医疗体系,并鼓励他们参与服务质量的竞争。
With the resources transferred from the central government and other provi nces and cities, the governments at various levels in the Tibet Autonomous Regio n have persisted unrelentingly in investment in the cause of people's health. On the one hand, they have, by means of government expenditure, maintained the thr ee-level health service network, on the other, they have employed relative polic ies to conduct health programs for the people assuming great risks in health. By doing so, they have not only made contributions to the improvement in health in dexes in the whole autonomous region, but also afforded other provinces and regi ons experiences for referential use in bracing public health in the process of e conomic 'commercialization'. However, the supply of health services in the grass -roots units is far from satisfying the demand of the people in the farming and stockbreeding areas in terms of convenience, timeliness and reliability, because the population in these areas are thinly scattered, the communications and tran sportation are inconvenient, and the health service organizations are weak in ab ilities. At present, the solution to this problem is, first, to improve the mana gement of health departments, and advance public health organizations' professio nal abilities and a bilities of going-from-place-to-place service; second, on th e basis of the limited medical market, and by adopting the systems of credential evaluation and regulations for medical reimbursement, to bring the service of v illage doctors in line with cooperative medical service system and encourage the m to participate in the competition in service quality.
出处
《管理世界》
CSSCI
北大核心
2005年第2期41-56,共16页
Journal of Management World
