通讯作者: 张研, zhangyan1604@163.com

DOI：10.12201/bmr.202402.00004

Analysis of the Management and Service Mechanisms in the Integration Dilemma of Medicine and Prevention in China

• 摘要：医防融合政策在我国的推进的效果有限，存在整合效率较低，供需双方对医防融合的共识不强等问题。本文分析了我国医防融合推进过程中的主要阻力在于重医轻防的观念、条块分割的体系架构、方向相悖的筹资和激励以及服务供给中分工和合作的根本矛盾。进而尝试从管理机制和服务机制的角度呈现我国医防融合的推进现状和改革桎梏，根源在于管理机制与服务机制不匹配。提出当前医防融合实践的改革逻辑应当首先以服务机制为抓点。明确医防融合的服务接口，建立以患者为中心的医防融合服务路径。在服务机制的建立中平衡效率与质量，在分工的基础上整合。再围绕医防融合服务机制进行管理机制的调整，在管理机制改革中协调多方主体利益，控制改革成本。

  关键词： 医防融合; 管理机制; 服务机制; 困境; 服务整合; 

   

  Abstract: The promotion of the integration of medicine and prevention policies in China has had limited effectiveness, with problems such as low integration efficiency and weak consensus between supply and demand in the integration of medicine and prevention. This paper analyzes the main obstacles in the process of promoting the integration of medicine and prevention in China, including the mindset of prioritizing medical care over prevention, fragmented system architecture, conflicting direction of funding and incentives, and inherent contradictions in the division of labor and cooperation in service provision. Furthermore, this article attempts to present the current status and constraints of medical and health integration in China from the perspectives of management mechanisms and service mechanisms, highlighting the mismatch between these two aspects as the root cause. It proposes that the reform logic of current medical and health integration practices should prioritize the service mechanism. This involves clarifying the service interface of medicine and prevention integration and establishing patient-centered service pathways for integration. In the establishment of the service mechanism, a balance should be struck between efficiency and quality, while also integrating based on division of labor. Subsequently, adjustments to the management mechanism should be made in accordance with the medicine and prevention integration service mechanism. In the reform of the management mechanism, various stakeholders interests should be coordinated and the costs of reform should be controlled.

  Key words: integration; of medicine; and prevention,management; mechanism,service; mechanism,dilemma,service; integration

  提交时间：2024-02-21

  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。
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• 序号	提交日期	编号	操作
  1	2023-10-10	bmr.202402.00004V1	下载

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