完善区域纵向医联体建设的思考——基于制度理性选择框架

区域纵向医联体是我国医疗卫生体制改革的重要举措。该制度的出台源于我国医疗服务体系的"金字塔"型架构与医疗资源配置和患者就医的"倒金字塔"型现状的矛盾。但受旧有医疗卫生体制的惯性、配套政策滞后、患者认同度低等因素的影响,医联体建设仍面临着诸多瓶颈。基于制度理性选择框架的分析发现,医联体制度的行动舞台呈现与医联体的制度设计存在明显偏差。需要构建长效治理机制重构行动舞台,才能实现医联体制度的建设初衷。

Thoughts on improving the regional longitudinal health consortium:A framework analysis of institutional rational choice

Regional longitudinal health consortium is an important measure of the health care reform. The purpose of making the system is to solve the conflict between the pyramid configuration of the medical service system and the inverted pyramid of the resources allocation and medical treatment of patients. But owing to the inertia of the previous system,the incomplete supporting policies and lack of mechanism innovation, the regional longitudinal health consortium faces many bottlenecks. Analysis based on the framework of institutional rational choice shows that there is an obvious deviation from the system design and the stage show of the health consortium. Therefore, in order to achieve the original intention ultimately, it needs to build long-term governance mechanism to reconstruct the stage of action.