励精图治 开创卫生改革新局面——在2001年全国卫生工作会议上的讲话（节选）

回顾过去的2000年,卫生改革与发展的任务十分繁重。在党中央、国务院的直接领导下,卫生改革与发展取得了突破性进展。 一年来的卫生改革与发展的实践表明,人民群众对医疗卫生体制改革是肯定的,对卫生工作是肯定的。这更加坚定了我们坚持为人民健康服务、为杜会主义现代化建设服务的卫生工作方针,坚定了坚持全心全意为人民服务的根本宗旨的决心,坚定了以改革创新的精神,发展我国卫生事业的信心。     

制约青岛市卫生行政执法发展的因素及对策

按照《中共中央、国务院关于卫生改革与发展的决定》，1999年青岛市卫生监督体制改革拉开帷幕，经过几年的改革与发展，卫生监督执法工作取得了长足的进步，正向着建立一只职责明确、行为规范、执法有力、保障到位的卫生监督体系而努力。但是，卫生监督执法工作还存在许多问题，影响了卫生监督执法工作深层次的发展。     

国际卫生改革发展趋势及启示

2008年11月，卫生部组织的第三期中国卫生发展与改革国际高级研修班先后在我国清华大学和美国哈佛大学进行了为期四周的学习研究。其间大量涉及卫生政策制度和体制分析、国际卫生改革与发展走向、卫生资源管理、卫生人力发展等内容，令人耳目一新     

体制变革过渡期的卫生防疫工作

全国卫生工作会议确立了我国卫生体系改革的基本框架,到２０００年,初步建立起与我国现代化建设相适应的卫生监督执法体系。这一目标的实现,将结束我国建国后几十年来由各级卫生防疫站同时承担卫生监督和卫生防疫工作的历史使命,这对各级卫生防疫站造成的影响将是重大而深远的。如何适应这一改革,是各级卫生防疫站近期所普遍关心的问题。对此,我站从１９９７年底开始,通过对卫生防疫站内部机构设置的调整、工作职能的转换、工作方法的转变和管理手段的改变,进行了一些探讨,实现了卫生防病与卫生监督工作的同步发展和两种效益的显著…     

加拿大卫生改革现状、发展趋势及其对我国的启示

全民医疗保健制度是加拿大卫生体系乃至社会政策的核心,经济起伏下的筹资增减深刻影响到加拿大近二十年卫生发展历程,以公平、公正为基本价值观,构建低成本高效益卫生服务体系,为全民及时提供高质量卫生服务是加拿大卫生改革发展的基本趋势。本文介绍了上世纪后十年和本世纪初十年两阶段的加拿大卫生改革的背景、现状、特征、主题、内容、影响、经验和教训,并从公平、效率和长期性三方面阐述了对我国卫生改革发展的启示。     

镇江市卫生经济学会成立20周年纪念大会暨2005年学术研讨会在句容召开

镇江市卫生经济学会成立20周年纪念大会暨2005年学术研讨会于2005年12月14—16日在风景如画的句容召开。学会理事及论文作者共舳位代表参加了会议。《中国卫生经济》杂志社、《卫生经济研究》杂志社、江苏省卫生经济学会发来了贺电、贺信。学会会长许黎明同志作了题为《在卫生改革中诞生在卫生改革中发展——镇江市卫生经济学会成立20周年回顾与展望》的工作报告。镇江市区、     

我国卫生服务体系的调整与改革

卫生服务体系、医疗保障体系和卫生执法监督体系构成了我国比较完整的卫生体系。我国卫生服务体系是建国以后在计划经济体制下建立和发展起来的。我国卫生服务体系改革与发展的思路,应以有效性和经济性作为标准,评价我国卫生服务体系的利弊。对我国现有的卫生服务体系进行调整与改革,构建一个更加有效、经济的卫生服务体系。卫生服务体系的调整与改革能否顺利进行,关键是改革卫生管理体制,实施区域卫生规划。     

试析卫生经济改革活动中三项基础性工作

卫生经济改革是卫生改革的重要组成部分。在当前及今后所要解决的卫生问题中,其中加强农村卫生和预防保健工作、完善医疗保障制度、解决卫生资源投入不足和浪费并存、医药费呈不合理增长等问题,与卫生经济改革有直接和密切的关系。为解决这些问题,中央提出今后卫生经济改革的方针和政策,明确了卫生经济改革的方向,确定了卫生经济改革的重点。通过学习《中共中央、国务院关于卫生改革和发展的决定》(以下简称《决定》),笔者认为,在卫生经济改革中,有三项基础性工作,即区域卫生规划、基本卫生服务的界定和卫生服务成本核算,将贯穿于卫生经济改…     

总结经验 面向未来 开创学会工作的新局面

一、卫生经济研究的回顾 自1997年以来,根据卫生改革与发展的新形势,中国卫生经济学会着重进行了以下几方面的卫生经济理论与应用研究: (一)关于卫生改革的环境和政府职能的研究 卫生事业在国民经济和社会发展中发挥着不可替代的作用。卫生发展必须纳入国民经济和社会发展的总体框架。宏观经济体制改革的总体思路和重大举措必然辐射和影响到卫生改革与发展。在探讨我国卫生改革的理论与政策时,必须注意到国有企业改革、预算会计制度改革以及财政、金融、税收、价格等经济政策调整对卫生     

对卫生改革的思考和展望

在我国改革的大潮中,卫生改革已历经十一个春秋。卫生改革的目的,就是要使卫生体制、健康制度和运行机制与社会主义现代化建设相适应,卫生生产力的发展与社会生产力的发展相适应,卫生事业的发展与保障人民健康的基本需求相适应。未来十年的卫生改革,将是关键性的十年,也是卫生事业在深化改革中再展宏图的十年。     

卫生改革发展要处理好的几个关系

我国医药卫生体制改革已经进入攻坚阶段,本文结合卫生事业发展规律和卫生改革实践,认为深化卫生改革需要从宏观和微观两个方面进行进一步调整.宏观方面需要进一步处理好卫生与经济、改革与发展、医疗保障多数与少数、政府投入常态与专项等关系,微观方面需要进一步处理好基本医疗和特需医疗、公立医院改革的公平与效率、体系建设的人才与硬件等关系,并就如何处理好这些关系提出相应建议.     

Recent issues of the Romanian health financing system

The aim of the paper is to examine the health financing reform in Romania in order to find out to what extent the expected results were achieved, what were the main factors that influenced the reform process and in what way the main unsolved problems are to be sorted out. The paper describes the main features of the health financing reform outlining the factors that determined or influenced it, presents some of the reform outcomes and discusses the current health policy agenda. The main findings of this examination are the following: the expected results of the health care reform were not fully achieved (one of the main causes was the too high expectations that did not take into account the country’s low starting point at the beginning of the transition); the reform process was slowed down mainly by political instability, the funds for health increased over time, but this was not enough to increase health system performance and patient satisfaction, the health system reform finally became one of the main priorities on the government agenda. The paper concludes that it took quite a long time until the Romanian government took over its stewardship role of the health system, with the understanding that health reform cannot be a separate process but rather is in need of intersectorial action, clear and coherent legislative support and strong political backing.     

Political analysis of the conception of the Polish National Health Fund

Background After the fall of communism, Poland implemented one of the widest reaching programmes of socio-economic reforms. However, in comparison health system reforms were less radical. At the end of the 1990s a change process had been started, but the political fight for power has heavily influenced the health reforms and led to two different reform concepts being implemented over a period of a few years. Aim The paper assesses the chances of implementation of the reform proposed in 2001 to recentralise health financing and organisation by replacing regional sickness funds by a National Health Fund. A hypothetical model is proposed which is placed at the start of the reforms and compares the model to the actual political course observed. Methods PolicyMaker software was used for a political mapping analysis. The policy content (goals and mechanisms) was based on official political documents as well as verbal declarations made by key policymakers in the media, newspapers and magazines. Results The analysis showed that the political situation was in favour of the government implementing a single National Health Fund. Nevertheless, this generated a strong resistance by the political opposition, experts and health care workers which could be a substantial obstacle for the realisation and effectiveness of the implemented model. The feasibility of the project could have been increased by implementing a number of strategies aimed at modifying the attitude of key stakeholders and by introducing the proposed reform as part of an overall improvement of the work environment for health professionals. Conclusions The concept of a National Health Fund generated important opposition against the proposed changes in the health care system. With its majority in Parliament, the government was nevertheless able to establish the new system. The actual course of the reforms however contained a large number of formal errors, which led the Constitutional Court to rule the reform as unconstitutional. Substantial imperfection of the reform caused a destabilization of the whole health care system. In addition, defeat of the reform caused a decrease of electoral support for the governing coalition.     

澳大利亚卫生人力资源管理改革及对我国的借鉴意义

自2007年底,澳大利亚政府实施自1984年引入全民医疗保险制度以来规模最大的一次医疗体制改革.在本轮医改中,澳大利亚政府出台了一系列加强卫生人力资源管理的重要举措,如新设独立的卫生人力管理机构、成立统一的注册和认证机构、加大卫生人力资源经费投入、创新管理体制和机制及制定全面卫生政策来引导卫生人力向基层流动.本文简要介...     

落实“十五”发展纲要 构筑新型卫生体系

该文全面阐述了实施《上海市卫生事业发展第十个五年计划纲要》的重要意义 ,进一步明确了实施《纲要》必须坚持以发展为主线 ,强调了改革是推进卫生事业发展的强大动力 ,法制和规制建设是卫生改革与发展的必要保障 ,并提出要正确处理好几个关系 :( 1 )正确处理好政府与市场的关系 ;( 2 )处理好公共卫生与医疗卫生的关系 ;( 3)处理好城市卫生与郊区卫生的关系 ;( 4 )处理好改革发展和规范合理的关系     

Mental health system reform in Moldova: Description of the program and reflections on its implementation between 2014 and 2019

In 2014, the Republic of Moldova started a systematic process of reforming its mental health system, implementing priority actions set out in the National Mental Health Programme. The reform entailed a service delivery re-design, instituting mechanisms for collaboration across health and social sectors, and revision of the policy framework. Outcomes of the first 4 years of the reform included: 1) the establishment of a network of mental health services in 4 pilot districts embedding mental health diagnosis, treatment and referral in primary and specialized mental healthcare; 2) creation of an enabling policy environment at the national and district level; and 3) strengthened community support and acceptance of mental health issues. Objectives of the first Phase were achieved and the reform is now in its second Phase (2018–2022). The implementation strategy in Phase 1 focused efforts on 4 pilot districts, whereas Phase 2 harnesses lessons learned from Phase 1 and facilitates local leaders and actors to scale-up the model to all 32 districts and municipalities in Moldova. Ownership over the reform process shifted from project-led in Phase 1 to national and local government-led in Phase 2. We reflect on the process and contents of the mental health reform, discuss lessons learned and implementation challenges encountered. We conclude with learning points for policymakers and researchers considering mental health reform in other countries.     

深化卫生改革促进卫生事业与社会经济协调发展

该文首先回顾了改革开放以来上海卫生经济领域发生的历史性巨变,接着分析了卫生经济领域目前面临的一系列问题与挑战。文章最后提出要采取宏观调控卫生资源甚量,完善医院补偿机制,推进医院综合改革,转变医疗消费观念,开展多层次服务等措施迎接挑战,深化卫生经济改革,促进卫生事业与社会经济协调发展。     

新乡市卫生监督体制改革十二年效果浅析

目的：对新乡市卫生监督体制改革效果进行评价。方法：通过对新乡市卫生监督体制改革12年来工作开展情况及有关数据进行比较分析。结果：①改革总体效果良好，达到了预期目的；②这次改革存在一些不足和缺陷，如对疾病控制机构带来较大冲击。结论：建立适应社会主义市场经济需求的卫生监督和疾病控制体系是历史的必然，在深化改革的进程中，必须统筹兼顾，均衡发展。完善疾病控制机构补偿机制和规范卫生监督工作是今后应关注的重点。     

我国医药卫生与医疗保障和社会经济协调发展战略研究

描述了目前国内任何地区的区域卫生规划研制和实施时面对的中短期（2－5年内）工作重点－我国医药卫生、医疗保障和社会经济协调发展战略。我们认为要形成卫生事业与社会之间的协调发展状况,必须在短期内克服和解决四方面逻辑相关的问题：如社会和卫生两方关注的表现问题得不到有效解决;医保改革将缺乏有效运作条件;两者也导致医院内部改革缺乏动力,卫生事业发展 突破性进展;区域卫生规划在上述基础上极有可能流于形式。另外,医疗卫生机构在体制和产权制度方面的改革滞后于宏观神经经济改革的进程,也给上述问题的解释和解决披上了模糊的色彩,文章依据研究结果,分步阐述了短中期规划中的工作重点。