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卫生体制是卫生服务供给的制度化,是界定政府在卫生中角色的前提。经验结果显示,OECD国家政府的融资和监管角色均有不同程度的加强,且存在趋同和共同的趋势,而在服务提供功能上却存在弱化的趋势,尽管没有趋同。体制缺陷和政策学习是促成政府角色变迁的客观和主观条件,前者决定变迁的必要性,后者决定变迁机制,如变迁的内容、时间和速度。文章的初步结论是对于我国卫生体制及其改革的研究和实践不无裨益。
Health system is the institutionalization of the supply of health services, which is the precondition of defining the government’s role in health. The empirical results show that the financing and regulatory roles of OECD governments are strengthened to some extent, and there is convergence and common trends. However, there is a weakening trend in service delivery functions, though there is no convergence. Institutional defects and policy learning are the objective and subjective conditions that lead to the change of government’s role. The former determines the necessity of change, and the latter decides the mechanism of change, such as the content, time and speed of change. The preliminary conclusion of the article is not without benefit to the research and practice of China’s health system and its reform.