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从国际卫生服务领域改革与发展的趋势来看,卫生服务的供给已经开始从过去的等级性、综合性的集权供给方式向基于供需分离的购买服务模式转变〔1〕。在这一模式中,购买什么样的卫生服务,从哪里和如何购买卫生服务等都在事先就已经决定〔2〕。在欧洲一些国家,已经从卫生服务的集权管理模式转变成基于供需分离的购买模式,即政府与私立部门,以及保险机构(第三方支付者)在组织形式上与卫生服务提供者分离〔1-3〕。卫生服务购买模式的出现不仅引起了国际社会的广泛关注,而且,在中国的卫生改革与发展过程中也开始实施并探索这一改革措施。
From the perspective of the reform and development in the field of international health services, the supply of health services has begun to shift from a hierarchical and comprehensive centralized supply model to a purchase-service model based on separation of supply and demand. In this model, what kinds of health services are purchased, where and how to buy health services, etc. have been decided beforehand [2]. In some European countries, the mode of centralization of health services has been transformed into a purchase model based on the separation of supply and demand, that is, the government and the private sector, as well as the insurance institutions (third-party payers), are organized and separated from the health service providers [1- 3]. The emergence of the mode of purchase of health services has not only drawn wide attention from the international community, but also begun to be explored and explored in the process of China’s health reform and development.