| 摘要: |
| 为了合理利用区域医疗卫生资源，国家倡导建立分级诊疗制度以缓解“看病难、看病贵”问题。但在实际实施过程中，分级诊疗制度遭遇制度动力不足和实施效率低下等问题。基于新制度主义的理论观点，认为新制度的“合法性”危机、原有体制的路径依赖以及制度变革中的权力与利益博弈是产生分级诊疗制度化困境的原因。因此，我们应该创新分级诊疗制度，建立以政府与市场共同参与的分级诊疗实施网络，重新配置医疗卫生资源，完善社区医疗机构的“守门人”制度，加快社会组织的功能实现，实现分级诊疗制度的利益共享。 |
| 关键词: 新制度主义 分级诊疗 制度创新 |
| DOI： |
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| 基金项目: |
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| Research on the Innovation of Hierarchical Diagnosis and Treatment System Based on New Institutionalism |
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| Abstract: |
| In order to make rational use of regional medical and health resources，the state advocated the establishment of a graded medical treatment system to alleviate the problem of “difficult to see a doctor and expensive to see a doctor”. But in the actual implementation process，the hierarchical diagnosis and treatment system suffers institutional impetus insufficiency and the implementation efficiency is low and so on. The new institutionalism provides an analytical framework for explaining the institutionalized dilemma of hierarchical diagnosis and treatment in China. Based on the theory of new institutionalism，the paper argues that the crisis of the legitimacy of the new system，the path dependence of the original system and the game of power and interest in the system reform are the causes of the institutionalized dilemma. The hierarchical diagnosis and treatment system should be innovated，the network of graded diagnosis and treatment with the participation of the government and the market be established，the medical and health resources be re-allocated，the “gatekeeper” system of community medical institutions be perfected，the function of social organization be accelerated，and benefit-sharing be achieved. |
| Key words: neo-institutionalism,hierarchical diagnosis and treatment,institutional innovation |
