南非公立医院改革的主要做法与特点

相对于私立医院占有五分之三的卫生支出为20%的人群提供服务,南非公立医院约使用五分之二的卫生支出,为南非80%的人群提供医疗卫生服务,但面临着资源不足和人力短缺的问题。为此,南非政府着重建立公平导向的卫生管理体制,加大政府财政投入,重点保障基层公立医院发展,探索公私合作,在优先保障弱势人群基本医疗服务的同时,动员可利用的所有医疗资源,着力保障居民公平地获得基本医疗卫生服务。改革的主要特点是建立以基本医疗卫生保健为基础的医疗管理体制,以更公平的方式分配医疗资源,建立公私合作机制,动员民营机构力量,优先保障居民对基本医疗卫生服务的可及性和公平性。这些经验对于同属于发展中国家的中国有良好启示。

The main practices and features of public hospital reform in South Africa

Compared with private hospitals which account for three fifths of national health expenditures and provide services to 20% of population,South African public hospitals account for about two fifths of national health expenditures and provide medical and health services to 80% of South African population,however,South Africa is faced with the problems of insufficiency in resources and shortage in human power. For this end,the South African government pays close attention to establishing equity-led health administration system,increases governmental financial inputs,laying stress on ensuring the development of grassroots public hospitals,explores cooperation between public and private sectors,mobilizes all the medical resources available while ensuring the basic medical services for vulnerable population groups as a priority,and vigorously ensuring equal access by residents to basic medical and health services. The reform is featured mainly by: establishing a medical and health administration system based on basic medical and health care services; allocating medical resources in a more equitable manner; establishing a mechanism for cooperation between public and private sectors; mobilizing forces of private institutions; and ensuring residents’access to and equity in basic medical and health services. These experiences also offer a sound inspiration for China which is a developing country as well.