CAJ | 학술논문

卫生资源优先次序分配作为政府有效治理的重要领域，在我国仍缺乏类似层面的综合思考。西方在该领域的研究趋势已从单纯的经济学思考走向了政治经济学、制度约束、卫生筹资的全面分析，并在更宏大的组织和政治情境中，考量政府的治理范围、手段，建构操作性强的优先次序分配框架。在卫生决策实践中，找寻跨学科工具的最佳组合考验着决策者的治理水平。本文梳理政治学、卫生经济学、哲学、法学、循证医学等不同学科对卫生资源优先次序分配的思考。最后明确政府卫生资源治理的层次、治理策略建议，强调卫生决策从“作为结构的治理”走向“作为过程的治理”的发展规律因应我国所面临的挑战。
위생자원우선차서분배작위정부유효치리적중요영역，재아국잉결핍유사층면적종합사고。서방재해영역적연구추세이종단순적경제학사고주향료정치경제학、제도약속、위생주자적전면분석，병재경굉대적조직화정치정경중，고량정부적치리범위、수단，건구조작성강적우선차서분배광가。재위생결책실천중，조심과학과공구적최가조합고험착결책자적치리수평。본문소리정치학、위생경제학、철학、법학、순증의학등불동학과대위생자원우선차서분배적사고。최후명학정부위생자원치리적층차、치리책략건의，강조위생결책종“작위결구적치리”주향“작위과정적치리”적발전규률인응아국소면림적도전。
Priority setting of health resource allocation depends on effective and comprehensive government-based stewardship, the national research of which lacks comprehensive considerations. The paper articulates the trend of western research from solo economic analysis to a combined comprehension of political economies, systemic con-straints and health financing, to consider the scope, strategy and enforced framework for government rationing within a larger organizational and political context. In the health decision-making practice, the best formula for interdiscipli-nary tools is a test of stewardship capacity. A multi-disciplinary approach from the perspectives of politics, health e-conomies, philosophy, law and evidence-based medicine must be adopted for the priority setting of health resource al-location. Finally, a clear stewardship phased objective is proposed as well as strategies, with emphasis on health de-cisions from “stewardship as structure” to “stewardship as a process” with challenges that lie ahead.