“防–治–保”三位一体融合协同概念框架和路径初探

A conceptual framework and path of integration of systems of public health, medical service and health financing in China

摘要: 本文基于系统论、协同学等理论基础，通过文献回顾与理论分析，总结归纳公共卫生服务、医疗服务和医疗保障体系各自的功能、结构、特征以及3者交叉融合的关系；借鉴Donabedian模型，构建“公共卫生 – 医疗服务 – 医疗保障”（以下简称“防 – 治 – 保”）三位一体融合协同的概念框架；借鉴国际经验和已有的案例研究，提出“以点带面，从线到片，逐步形成”的“防 – 治 – 保”三位一体融合协同的发展路径。

Abstract: Based on a narrative literature review, we summarized structures, functions, characteristics of and relationships among China′s public health system, medical service and health financing system. A conceptual framework of integration of systems of public health, medical service and health financing the ‘three-in-one’ for short was developed by using the Donabedian model for healthcare improvement. A development path to ‘three-in-one’ was put forward, which synthesizes evidence, recommendations and best practice from other countries and implementation case studies in China.