| 摘要: |
| 基于系统文献综述的方法与治理的相关理论与实践，本文系统梳理了卫生部门治理的基本逻辑架构及关键要素，即问责(Accountability)、公开(Transparency)、参与(Participation)、廉政(Integrity)，以及政策能力(Capacity)；并在此基础，系统阐述了每个要素的基本概念及相关的政策与管理工具，以及多元主体在治理架构中所形成的权责矩阵关系。在实践中，通过排除了筹资、法律或基本战略思路等问题后，相关政策失败的原因都可以归纳为这5个关键要素所存在缺陷，要不是过分强调或完全忽视某一个要素，要不就是机械性的实施，而不是在实践中采取因地制宜的措施等。因此，这5个关键要素相辅相成，相得益彰，不仅构建了卫生部门治理的基本逻辑架构，也决定了其相关政策的决策模式，其目的在于识别实际或潜在的治理问题，并通过形成一种包容与相互促进的治理架构，以及能够体现其治理主体价值理念的模式与机制来促使相互冲突或不同利益相关者之间的协调，并形成一种包容合作与持续发展的方式来改善医疗卫生服务的供给问题，以及资源的利用效率。 |
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| Basic logic framework and key elements of health sector governance |
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| Abstract: |
| This paper systematically analyzes the basic framework and key elements of health sector governance, such as, accountability, transparency, participation, integrity, and capacity of policy, based on the method of systematic literature review and related theory and practice of governance. However, systematically expounding the concepts of each element and the associated policy and managed tools, as well as the authority-responsibility relationship of pluralistic subjects in the governance framework. In practice, by excluding the problem such as financing, legal or basic strategic ideas, the reasons for the policy failure can be summarized as defaults in the five key elements, either overemphasized or completely ignored an element, or that is mechanical implementation, rather than in practice to adopt measures suiting local conditions. Thus, these five key elements are mutually reinforcing, not only to build the basic framework of the health sector governance, also determines its policy decision-making pattern, which aims to identify actual or potential governance problems, and through forming an inclusive and mutually reinforcing governance framework, as well as pattern and mechanisms capable of embodying their governing bodies’’ values to coordinate the conflicting or different stakeholders. And form a cooperation and sustainable development way to improve the supply of the medical and health services, and the use efficiency of resources. |
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