“醫改”中的衛生部門:組織力量、行動策略與政策輸出:以福建省衛生廳為例

Research output: Contribution to journalArticles

Abstract

在中國的醫療衛生體制改革中,衛生部門居於非常重要的位置。現有文獻對於中國衛生部門的弱勢、“保護主義”和部門利益的分析雖然有一定意義,但卻未能對其官僚制基礎、政治地位、現實處境和組織能力進行全面考察,作出更加接近事實的分析。論文通過對福建省衛生廳2005年以來領導的一項以控制醫療費用過快增長為主要內容的政策干預的研究發現,地方的衛生部門並非缺乏改革的意愿,亦非全然是改革的阻礙力量。問題的關鍵在於來自外界的政策壓力、來自政府的政治支持、衛生部門自身的政策決心,以及發動、使用、配置現有行政資源和政策工具的能力。
The Chinese health bureaucracy plays a vital role in this country’s healthcare reforms. However, plenty of criticism prevails in the literature on its weak bureaucratic power, protectionism over health facilities, and self interest, which has led to the conclusion that the Chinese health bureaucracy is inherently incapable of leading reforms. However, this article finds that similar conclusions are unfortunately based on inaccurate depictions of the health bureaucracy’s political standing, situation, and capacities. By examining a healthcare reform led by Fujian Provincial Health Bureau that is committed to cost containment, this article argues that the local health bureaucracy does not truly lack the motivation for reform, nor is it a hindrance. The key to understanding this reform lies in three aspects, which are political support from the government, policy determination of the health bureaucracy itself, and appropriate alignment of policy instruments at its disposal. Copyright © 2011 廣東人民出版社有限公司; 廣東省治理現代化研究所.
Original languageChinese (Traditional)
Pages (from-to)97-115
Journal公共行政評論
Volume2011
Issue number2
Publication statusPublished - 2011

Citation

和經緯(2011):“醫改”中的衛生部門:組織力量、行動策略與政策輸出:以福建省衛生廳為例,《公共行政評論》,2011(2),頁97-115。

Keywords

  • 組織力量
  • 行動策略
  • 醫改
  • 衛生部門
  • 福建
  • 醫療衛生政策
  • Bureaucratic power
  • Strategy
  • Healthcare reform
  • Health bureaucracy
  • Fujian
  • Health policy
  • Alt. title: The Chinese health bureaucracy in healthcare reforms: Bureaucratic power, strategies and policy output