中国全科医学 ›› 2021, Vol. 24 ›› Issue (22): 2757-2764.DOI: 10.12114/j.issn.1007-9572.2021.00.203

• 专题研究 •    下一篇

英国卫生服务购买经验及启示

张小娟1,2*,朱坤3   

  1. 1.100020北京市,中国医学科学院医学信息研究所 2.100872北京市,中国人民大学公共管理学院 3.100142北京市,中国财政科学研究院
    *通信作者:张小娟,副研究员;E-mail:zhangxiaojuan@imicams.ac.cn
  • 出版日期:2021-08-05 发布日期:2021-08-05
  • 基金资助:
    国家自然科学基金资助项目(71573276)

Healthcare Procurement of Clinical Commissioning Groups in the UK:Experience and Implications 

ZHANG Xiaojuan1,2*,ZHU Kun3   

  1. 1.Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China
    2.School of Public Administration and Policy,People's University of China,Beijing 100872,China
    3.Chinese Academy of Fiscal Sciences,Beijing 100142,China
    *Corresponding author:ZHANG Xiaojuan,Associate professor;E-mail:zhangxiaojuan@imicams.ac.cn
  • Published:2021-08-05 Online:2021-08-05

摘要: 战略性购买是我国提高医保资金利用效率的关键举措。英国卫生筹资制度虽然不是社会医疗保险模式,但其卫生服务购买组织——临床委托服务组织(CCGs)为我国实施战略性购买提供了一些有益的经验。推行初级卫生保健是实现“人人享有卫生保健”的关键和基本途径。全科医生加入并领导CCGs使得采购组织能够直接了解患者需求,而且有能力跟卫生服务提供方对话,这是实施战略性购买的基本前提。另外,CCGs是自下而上由全科诊所自发形成的,有不同的规模和治理结构,完全基于各地的实际需要并有助于满足群众的需要,有利于确保服务质量的持续改进、减少不公平、保障选择权和患者参与,并促进整合型卫生服务的提供,减少住院服务利用,提高资金利用效率。

关键词: 临床委托服务组织, 整合型服务, 战略购买

Abstract: Strategic procurement is a key way to improve the utilization efficiency of health insurance fund. The financing of England is not the bismarck model,but Clinical Commissioning Groups(CCGs) still can provide some experience for strategic procurement in China. The promotion of primary healthcare is important to achieve "healthcare for all". General practitioners being involved and responsible for CCGs enable purchasers to have a good understanding of residents' healthcare needs,so that they can communicate with suppliers more effectively,which is the essential premise of implementing strategic procurement. CCGs are formed by general practice clinics spontaneously using a bottom-up approach,which are totally built on the special local situation with differences by scale and governing structure,aiming to help to satisfy residents' healthcare needs,ensure continuous improvement of service quality,reduce healthcare inequality,ensure the right for choosing healthcare and patient participation,promote the provision of integrated health services and reduce the use of inpatient services.

Key words: Clinical commissioning groups, Integrated care, Strategic purchasing