CAJ | 학술논문

以广州市统计局提供的第六次人口普查数据作为人口统计数据源,以天河区卫生局提供的社区医疗机构数据作为社区医疗服务研究数据源,以广州市天河区作为研究案例,总结出社区医疗服务存在政府供给、单位制供给、集体经济供给、社会力量供给4种模式.各供给模式均具有受卫生局领导、政府部门监管和作为城市医疗体系的基础等一系列共性,同时在供给主体、服务对象、筹资与财务管理和人事管理等方面存在差异性,形成相互补充的多元模式共存体系,社区医疗服务的准公共物品属性、社会经济体制转型与城乡二元体制、居民的多元化需求和不同供给主体的利益诉求综合作用是多元模式共存的机制.只有充分利用多元模式供给主体、全方位协调机制要素、进行合理的制度设计,才能更好地促进社区医疗服务均等化,同时为其他城市公共服务供给提供参考借鉴.
이엄주시통계국제공적제륙차인구보사수거작위인구통계수거원,이천하구위생국제공적사구의료궤구수거작위사구의료복무연구수거원,이엄주시천하구작위연구안례,총결출사구의료복무존재정부공급、단위제공급、집체경제공급、사회역량공급4충모식.각공급모식균구유수위생국령도、정부부문감관화작위성시의료체계적기출등일계렬공성,동시재공급주체、복무대상、주자여재무관리화인사관리등방면존재차이성,형성상호보충적다원모식공존체계,사구의료복무적준공공물품속성、사회경제체제전형여성향이원체제、거민적다원화수구화불동공급주체적이익소구종합작용시다원모식공존적궤제.지유충분이용다원모식공급주체、전방위협조궤제요소、진행합리적제도설계,재능경호지촉진사구의료복무균등화,동시위기타성시공공복무공급제공삼고차감.
@@@@Community health service is one of the key elements of basic public service that is community-oriented and to solve the basic medical needs of primary health service. The main structure and operation system of public service provision change because of China's social and economic transition. Community health service at the present stage has dual properties, the market mechanism is introduced into on the one hand, and traditional institutional characteristics still exist on the other hand. The paper uses the sixth census data provided by the Guangzhou Municipal Bureau of Statistics as a source of demographic data, community health care institutions provided by the Health Bureau of Tianhe District as the source of community health service, and takes Tianhe District in Guangzhou as a case to be studied. In the paper four types of supply models in community health services in Tianhe district in Guangzhou are summed up: government supply, work unit supply, collective economy supply and market supply. They are all under the leadership of the Health Bureau, supervised by the government and serve as the basis of the urban health care system. At the same time they have differences in the main supply, service targets, financing and financial management and personnel management. Both the common and different features of the various modes of supply form a complementary system of coexisting multivariate models. Based on the analysis of the coexistence of the multi-mode system, we draw the conclusion that the quasi-public properties of the community health services, the transformation of social and economic system and urban-rural dual system, the diverse needs of the residents and the interests of the different supply and their combined effects make the mechanism of multi-mode coexistence. Only taking full advantage of multi-mode supply, full range of coordination mechanisms and reasonable system design can gain access to equalization of community health services.