【作者】 赵琳；

【导师】 汪波；

【作者基本信息】 天津大学 ， 企业管理， 2010， 硕士

【摘要】 社区卫生服务作为我国城市医疗卫生体系中最基础的组成部分,也是实现“人人享有基本医疗卫生服务”的新一轮医药卫生体制改革目标的关键。社区卫生服务机构是公共卫生和基本医疗的服务载体,需要政府加大投入和补偿,本文立足于实现政府投入的科学性和高效率,运用公共管理及公共产品理论和复杂系统理论的基本原理,对我国城市社区卫生服务政府投入系统进行了深入分析和研究探讨。本文的研究思路为:明确社区卫生服务政府投入系统的四大责任主体,即政府、社区卫生服务机构、居民和医保机构——分析四大主体在系统中的功能及责任——运用相关技术分析方法研究四大主体间的关系——构建科学合理的运行机制以优化系统运作效率。按照上述研究思路,本文对系统内部主体特征与外部环境等影响因素进行分析,并在此基础上采用系统动力学建模方法,逐步构建出我国城市社区卫生服务政府投入系统的概念模型、逻辑模型以及SD模型,明确系统中存在的主要问题:政府投入不足与补偿机制不健全、社区卫生服务人力资源数量不足、医保政策对社区卫生服务的优惠不明显、居民对社区卫生服务机构的认知程度不高等。在上述研究的基础上,本文进一步结合天津市及天津滨海新区社区卫生服务进行实证研究,提出一系列具有针对性的可供全市参考的社区卫生服务的政策性建议,为实现公共型政府的职能和效能提供一定方法和路径,并促进医药卫生事业改革具体方案的有效落实。更多还原

【Abstract】 AS the most basic part of urban health system, Community Health Services is also the key in achieving "universal access to basic health services”: the goal of the new round medicine health organizational reform. Community Health Services, which is the carrier of the public health and basic medical service, needs the government to expand the investment compensation. Based on realizing scientific and high efficiency of government investment, this paper uses public management theory and the basic principles of complex systems theory to analyze Urban Community Health Service government investment system.The research idea is: clearing the four main responsibilities of the system community health services, namely, government, community health services organization, residents and health care institutions– analyzing the main functions and responsibility of the four parts -- using related technology to study the relationship between the four parts -- building a scientific and rational operating mechanism to optimize the system efficiency. In accordance with the idea above, the paper analyzes the features of the inside main responsibilities and outside environment factors of the system, on this basis ,uses system dynamics modeling method to gradually build up the concept model, logical model and the SD model of our urban community health service government investment system, and clear the main problems of the system: lack of government investment compensation, the number of community health services human resources is inadequate, the health insurance policies benefits to community health services is not obvious, residents’cognition of the community health services is not enough.Based on these studies, the paper studies the community health services of Tianjin and the Tianjin BinHai New Area, proposes a series of suggestions for the city’s community health services, policy recommendations, in order to provide a method and path for achieving the functions of public-oriented government, and to promote the specific programs of medical and health care reform effectively implemented.更多还原