Australian health system and its value to China's health reform and development
Australian health system and its value to China's health reform and development
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澳大利亚卫生体系及其对中国卫生改革和发展的价值
DOI：
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
Liu Zhi
中科院分区：
文献类型：
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作者：
Liu Zhi
目的研究澳大利亚医疗保健制度和历史。讨论和解决中国卫生体制改革中的具体问题。方法分析澳大利亚国民卫生体系的主要体系特点、卫生投入来源、卫生支出分配情况。与当前中国卫生体制相比，分析中国体制改革的问题和障碍，并讨论切实可行的解决方案。结果澳大利亚政府对医疗卫生服务的投入远远超过中国。国家和州政府承担主要的财政责任。医疗机构地理分布较为合理。结果全科医生与医院之间的转诊制度十分完善。相反，中国政府对医疗服务的投入是不平衡的。卫生资源的分配是分散的并且基于机构导向的方法。这些问题的出现，都与监管不力，特别是卫生部门的指导和监管不到位密切相关。市场制度引入和前期计划/政府干预背景下医疗机构追求利润的现象明显减少。结论我国应从以下几个方面进行卫生改革：（1）以人为本、注重配置效率，改进卫生资源配置。以充分的信息支持和利益相关者分析为基础，形成和强化双向“把关人”转介制度。 (2)理顺卫生服务提供体系，政府、社区和个人公平分担卫生责任。提高全民医保水平和全民覆盖水平。
Objective To study the system and history of Australian health care. To discuss and solve specific problems in the reform of Chinese health system. Methods Analysis of Australian national health system’s main features of the system, sources of health investments, distributions of health expenditure. Compared with current Chinese health system, problems and barriers of Chinese system reform will be analyzed, and then practical solutions will be discussed. Results Australian government investment in health service is far more than China. The national and state government take major financial responsibilities. The geographic distribution of medical institution is relatively reasonable. Results system of transferring between GP and hospitals is perfect. On the contrary, Chinese government investment in medical service is unbalanced. Allocation of health resources is fragmented and based on institution-oriented approach. All these problems are closely related to poorly regulated governance, especially insufficient guidance and supervision conducted by health departments. Medical institutions pursuit of profit in context of market institution introduced and previous planning/government intervention significantly reduced. Conclusion China is supposed to conduct the health reform through following aspects: (1)To improve health resource allocation through people-centred approach and focusing allocative efficiency. A two-way "gate-keeper" referral system should be formed and strengthened, based on sufficient information support and stakeholder analysis. (2)Health service provision system should be rationalized and health responsibility should be fairly shared among governments, communities, and individuals. National health insurance and its universal coverage should be improved.