城乡医疗卫生资源配置均等化问题研究——以常熟市为例-公共管理学专业论文.docxVIP

本文从公共物品理论、政府职能以及公平效率理论出发，基本 医疗卫生服务包括基本医疗和公共卫生服务，具有公共物品的性 质，应该均等地向全体居民提供，卫生资源的均等化配置，体现了 对基本健康权的维护，具有内在的公平性。然后，本文在描述我国 医疗卫生资源配置历史沿革的基础上，从国家宏观层面对卫生投 入、卫生人力、卫生物力等卫生资源在城乡的配置现状进行了实证 分析，分析了其不均等的现状，指出了其所致的医疗卫生服务的不 公平性、群众健康水平的差异和“看病难、看病贵”。同时本文从 常熟市的微观层面分析了城乡卫生资源配置的不均等，并对常熟市 近年来在促进城乡卫生资源均等化方面的一些做法进行了总结和 分析，提供借鉴。导致卫生资源城乡配置不均等的原因很多，本文 从宏观到微观几个主要方面进行了分析。城乡二元制度下重城轻 乡、重工轻农的政策使得卫生政策也偏向了城市，我国向市场经济 体制转型过程中卫生体制市场化，政府投入不足，价格决定资源配 置，产生了市场失灵，分税制后地方政府财权和事权不统一，乡镇 政府财政困境影响了对卫生的投入，僵化的卫生行政管理、人事管 理制度制约了卫生资源的优化配置。在分析原因的基础上，提出了 相应的政策建议，要统筹城乡协调发展，坚持政府主导进行资源配 置，完善财政体制，建立农村卫生投入长效机制，改革卫生行政和 人事管理制度，促进卫生资源的合理流动。 关键词：城乡，医疗卫生资源，资源配置，均等化 THE RESEARCH ON THE EQUALIZATION OF HEALTH RESOURCES ALLOCATION BETWEEN CITY AND COUNTRY ——TAKE CHANGSHU FOR EXAMPLE ABSTRACT Since the founding of New China，especially since the reform and opening up ， great achievements have been made in our hygienic industry which aims at defending the rights and interests of people’s health and improving people’s healthy standards during the whole process of social and economic development ． The major health indicators are among the front ranks of developing countries and have reached the average level of those middle and high-income countries． While during the fast development of the medical and health industry， the gaps in the medical and health services between city and country are becoming more and more apparent ， which is manifested on the inequality of the medical and health services enjoyed by people between city and country．However ,the fundamental reason under this issue is the unbalanced assignment of health resources between city and country． Recent years our government have come up with a series of reforming issues on the equalization of public services as well as the scientific outlook based on coordinating the development between city and country ．The new medical reform program has also required that the primary care systems should be further completed and developed between city，town and village，