通讯作者: 吕兰婷, lanting.lyu@ruc.edu.cn

DOI：10.12201/bmr.202210.00019

Research on the evolution and diffusion mechanism of drug negotiation policy in China*

• 摘要：国家药品谈判机制是当前我国推动医疗保障改革高质量发展的重要制度安排,本文在政策扩散理论视角下,从时间、空间、主体、内容和路径五个维度出发,探讨2009-2021年我国谈判药政策的扩散机制。结果表明,我国谈判药政策扩散存在一定的独特性,但整体符合我国医改特色路径。时间维度上,扩散曲线呈近似的S型分布；空间维度上,国家行政推动会改变层级效应和地缘邻近效应的效果；主体维度上,扩散主体的合作关系存在明显的阶段性；内容维度上,扩散后期更注重创新,政策的关注点呈现由服务创新逐渐向流程创新和辅助创新过渡、三者并行的趋势；路径维度上,以特殊药品管理和“双通道”机制为例,扩散路径分别为自下而上式和先自下而上后自上而下式,表现出地方政府探索、中央政府政策吸纳后垂直影响和高位推动的扩散模式。综合理解药品谈判政策创新扩散规律,为推进我国卫生领域公共政策创新扩散进程、保障政策落地质量提供参考。

  关键词： 药品谈判；政策扩散；政策演变；地方政府; ; ; 

   

  Abstract: The national drug negotiation mechanism is an important institutional arrangement to promote the high-quality development of Chinas medical security reform. Based on the policy diffusion theory, this paper discussed the diffusion process of Chinas negotiated drug policy from 2009 to 2021 from five dimensions of time, space, subject, content and path. The results showed that although the diffusion of negotiation drug policy in China was unique, it was basically in accord with the characteristic path of Chinas medical reform. In the time dimension, the diffusion curve presents an approximate S-shaped distribution; In spatial dimension, the promotion of State Administration can change the effect of hierarchical and proximity effect; In the subject dimension, there are obvious stages in the cooperation between the subjects; In terms of content, the policies pay more attention to innovation in the later stage and the focus of them gradually shifts from service innovation to process innovation and auxiliary innovation; In the path dimension, taking special drug management and two-channel mechanism as examples, the diffusion modes are of local government exploration, central government vertical influence and promotion after policy absorption. Comprehensively understand the regular pattern of drug negotiation policy diffusion, so as to provide reference for promoting the process of public policy diffusion in the field of health in China and ensuring the quality of policy implementation.

  Key words: drug negotiation; policy diffusion; policy evolution; local government

  提交时间：2022-10-25

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
• html

• 图表

• 李贤哲, 马继炎, 程昊哲, 杨明芳, 黄旸木. 地方政府层面的医药研发激励政策扩散研究. 2021. doi: 10.12201/bmr.202103.00007

  龚秀全, 白海宁. 上海安宁疗护政策扩散研究. 2022. doi: 10.12201/bmr.202209.00001

  裴晨阳, 胡琳琳, 刘远立. 我国老年健康服务政策的发展演变与未来建议. 2020. doi: 10.12201/bmr.202007.00026

  杜倩, 仇雨临. 基层政府创新及扩散研究——以整合城乡居民基本医疗保险政策为例. 2021. doi: 10.12201/bmr.202007.00027

  宋佳, 范成鑫, 王婉晨, 艾旭峰, 刘馨璐, 李翠玉, 张玉杰, 李秋莎, 王安琪, 丰志强, 尹文强, 马东平. 利益相关者视角下我国药品集中带量采购政策研究——基于政策工具的文本分析. 2022. doi: 10.12201/bmr.202203.00006

  李洪宇, 孙强. “两票制”政策对山东省药品供应状况影响分析. 2021. doi: 10.12201/bmr.202011.00015

  王苑如, 胡紫馨, 谢金平, 邵蓉. 欧盟罕见病药物资格认定管理政策分析及启示. 2022. doi: 10.12201/bmr.202207.00031

  李新宇, 邵蓉, 白铭钰, 李大双, 颜建周. 我国儿童药保障政策文本量化分析——基于政策工具、政策目标的二维框架. 2022. doi: 10.12201/bmr.202209.00016

  蒋明珠, 应晓华. 我国疫苗管理政策文本的量化研究 -基于政策工具、政策主体、政策落点的文本分析. 2022. doi: 10.12201/bmr.202212.00005

  石振宇, 加焱冰, 徐进, 袁蓓蓓, 孟庆跃, 何平. 我国卫生政策与体系研究的政策转化分析. 2020. doi: 10.12201/bmr.202006.00011

• 序号	提交日期	编号	操作
  1	2022-07-12	bmr.202210.00019V1	下载

• 公开评论  匿名评论  仅发给作者 提交评论