县域医共体与医保的协同发展：理论缘由、实践困境与优化策略

本文归纳了医共体与医保协同发展的理论缘由,并运用协同治理理论分析了当下医共体和医保协同发展的实践困境,进而提出了相应建议。研究认为,医共体和医保协同发展是协同治理应对复杂性公共管理问题的理论要求,也是“三医联动”改革实践的理论升华,更是构建整合型医疗卫生服务体系的内在要求。然而,当前二者协同还存在发展目标不明确、缺乏对元主体的清晰界定、多元主体参与不足以及协同措施碎片化的实践困境,未来需要以健康中国作为长期性共同目标,发挥党委、政府启动协同治理的元主体作用,吸纳多元主体参与协同治理并强化协同治理措施的系统性。

The collaborative development of county medical communities and medical insurance: Theoretical causes, practical dilemmas, and optimization strategies

The article summarizes the theoretical causes for the collaborative development of county medical communities and medical insurance, then analyzes the practical difficulties in the current conditions of their collaborative development with collaborative governance theory, and then puts forward corresponding suggestions. It suggests that the collaborative development of the county medical communities and medical insurance is a response to collaborative governance theories to deal with complex public management issues, a theoretical sublimation of the "integration of medical treatment, medical insurance and medicines supply" reform practice, and an inherent requirement for building an integrated medical and health service system. However, problems such as unclear development goals, lack of clear definition of meta governance subjects, insufficient participation of multi subjects, and fragmentation of collaborative measures is yet to be dealt with in practice. In the future, Healthy China ought to be taken as a common long-term goal, with Party committees and governments being the meta subjects of starting collaborative governance, absorbing multi subjects to participate in collaborative governance, and introducing the systematic collaborative governance measures.