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近几年食品安全危机事件频发,不仅影响到人民身体健康和生命安全,而且对经济发展和社会稳定造成了严重的冲击,食品安全问题越来越受到社会各界的关注。化解食品安全危机需要依靠多元主体协同治理,但是在现有体制框架内实现各主体协同与合作过程中却存在诸多困难,为此,需要完善食品安全法律体系,明确界定各主体的权力与责任,完善激励和监督机制,促使食品安全多元主体实现功能耦合。  相似文献
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Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept. The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non‐governmental status. Future policy and research priorities are outlined. Copyright © 2016 John Wiley & Sons, Ltd.  相似文献
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专利药医保准入谈判是治理体系现代化战略在医药卫生领域的重要突破,多元治理主体的加入非但没有削弱政府的重要性,反而赋予了政府作为治理体系“领导者”以更加丰富的内涵。本文整合了已有治理理论模型中关于领导者功能的论述,以其领导力发挥的内在机制为线索,创新性地构建了领导力分析的理论框架。基于专利药医保准入谈判治理的实质,本文结合典型国家的实践经验分析了政府领导力建构的模块和路径,一是提出和选择治理制度,包括药品价格谈判的启动机制与价值评估标准;二是选择治理主体并管理冲突,包括谈判博弈平台与风险共担机制的建设;三是确保治理过程的耦合协调,主要涉及与地方医保和临床使用的衔接。最后建议我国从行政性、适应性和赋能性三个层面继续加强专利药医保准入谈判治理中的政府领导力建设,以保证治理决策的公平与效率为前提,平衡潜在的利益冲突。  相似文献
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精神健康问题已成为影响经济社会发展的重大公共卫生问题和社会问题。基于社区的精神健康服务有利于精神疾病的早发现、早治疗、早控制,是促进精神健康的重要途径。我国当前的社区精神健康服务需综合运用健康治理、优势治理和协同治理的规律和方法,重组社区事务,建立协同平台,完善监护制度,加强考核评估的协同,提升服务能力,对社区居民不同的精神健康服务需求进行多层次、整体性回应。  相似文献
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