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分级公共卫生服务包需要社保助力

Hierarchical Basic Public Health Service Project needs the Assistance of Social Security

Theory and Practice of Social Work / 2020,2(3): 63-80  / 2020-07-28 985 1167

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• Authors: 明兰真¹²³⁴⁵⁶* 潘星亮⁶ 曾国清⁶ 闫安⁶ 欧佳⁶ 唐华丽⁶ 鲍雪琴⁶ 卜保鹏⁷
• Information:

  1．河北省计划生育科学技术研究院，石家庄；
  2．国家卫生健康委员会计划生育与优生重点实验室，石家庄；
  3．河北省生殖医学重点实验室，石家庄；
  4．河北静亮健康管理有限公司，石家庄；
  5．石家庄市德耀职业培训学校，石家庄；
  6．深圳市罗湖医院集团，深圳；
  7．河北中医学院，石家庄

• Keywords:
  Public health service packages; Graded public health service; Chronic disease management; Social security; Health finance; Health economy
  公共卫生服务包; 分级公共卫生服务; 慢病管理; 社保; 卫生财政; 卫生经济
• Abstract: There were more than 20 residents received health management for three months in Changling Community Health Service Center of Shenzhen Luohu Hospital Group. Through this way, it was divided into levels of primary, intermediate, advanced, and premium that the service contents of National basic public health service packages. Different health services were given to patients of hypertension or diabetes depending on their health demands. Among them, the lower the willingness was, the higher the service technology and ability were required, and the more difficult it was to establish the relationship between supply and demand. There were different sources of funds of graded public health service packages. The primary ones should be paid by the government, that was, the state provided funds to the supply-side and budgeted for personnel training and other expenses.The intermediate ones and the special service for family sickbeds should be paid by social security, that was, the state provided funds to the demand-side. The premium ones could be purchased through a combination of social security and out-of-pocket costs. Costs of basic public health services could be paid by the state, collectives and individuals, and a stable payment mechanism could be formed by it. New medical service model were formed between the server and the serviced in the process through market regulation in health economics, based on macro-control of health finance and total expenditure budget. It was both to improve the enthusiasm and sense of achievement of workers and to attract more of the transformation of medical staff to study more professional technology of health services, At the same time, the more satisfied residents were with health services, the more willing they were to buy them. The relationship of health services could be formed between supply and demand. The goals of transformation of medical service mode could be realized fundamentally that from disease to health, and from the biological model to the people-oriented model. 本文通过对深圳市罗湖医院集团的长岭社区健康服务中心的20位居民进行三个月健康管理，把公共卫生服务内容分为初级、中级、高级和特级四等九级的方式，阐释预防康复的健康服务，以高血压、糖尿病为例，通过根据居民对健康需求的不同，给与不同的健康服务。其中意愿度越低的人群，需要的服务技术和能力就越高，对建立供、需服务关系越困难。在分级公共卫生服务包中，初级服务包由国家买单，即财政资金补供方部分，同时预算出人才培养和其他消耗性资金等；中级服务包和家庭病床特级服务包由社保买单，即财政资金补需方部分。高级服务包可以由社保和自费相结合的方式购买。由国家、集体、个人共同承担，形成稳定结构。在卫生财政宏观调控、支出总额预算基础上，利用卫生经学的市场调节，驱动服务和被服务双方在服务过程中形成新型医学服务模式，提高服务从业者的积极性和成就感，以吸引更多的医务人员转型、不断研究具有更加具有专业水平健康服务技术；同时被服务者对健康服务的满意度，促进更多的居民愿意购买不同等级的健康服务，建立健康服务关系，从根本上实现以疾病为核心向以健康为核心的转移；以生物模式为主，向以人为本的转移。
• DOI: https://doi.org/10.35534/tpsw.0203011
• Cite: 明兰真，潘星亮，曾国清，等．分级公共卫生服务包需要社保助力［J］．社会工作理论与实务，2020，2（3）：63-80．