改革医疗体系和服务-石磊玉.pdfVIP

REFORMING HEALTH CARE SYSTEM AND DELIVERY 改革医疗体系和服务 Leiyu Shi （石磊玉）, Dr.PH, MBA, MPA Professor of Health Policy Management Director of Johns Hopkins Primary Care Policy Center 约翰霍普金斯大学公共卫生学院卫生政策与管理系 教授 约翰霍普金斯大学基本医疗政策研究中心 主任 2017 年6月 (2017 Copyrighted) Background 背景 • Reforming health care is a key challenge for almost every nation. 几乎每个国家都面临医疗改革的挑战。 • Low-income countries: provide basic health care across as much of the population as possible, for little money and limited resources. 低收入国家：以有限的资金和资源为尽可能多的人提供基本医疗服务。 • Emerging economies: deliver high-quality care at a price affordable to their new middle classes under available resources. 新兴经济体：以可负担的价格和可用资源为中产阶级提供高质量的医疗服 务。 • Developed nations: maintain equitable access to care and quality while controlling costs (efficiency) and balancing resources (distribution). 发达国家：控制成本和平衡资源的同时保持获得医疗服务的公平和医疗质 量。 • Despite differences in priorities, containing cost and maximizing limited resources are common challenges for all nations. 尽管优先级不同，控制成本和最大化利用有限资源是所有国家的共同挑战。 Healthcare Reform Is Particularly Challenging for US and China 医疗改革对美国和中国尤其具有挑战性 High Cost, Average Outcome, and Low Equity Within USA 美国医疗成本高，效果一般、公平性低 • Most costly healthcare system in the world (specialization, medical technology, multi-stakeholders, and inefficiency) 世界上最昂贵的医疗体系（专业化，医疗技术，多方利益相关者和低效率） • Large elderly population and chronically ill 老龄化、慢性病 • Disparities in access, quality, and outcome across racial/income/insurance groups: an increasing social problem 不同种族/收入/保险群体间在医疗可及性、质量和结果方面存在差距：越来越严重的社会问题 The Uneven Development Within China 中国发展不均衡Adapting to China’s Situation 适应中国的情况 • Most populous (1.3 bi