[1]潘 迪,赵 阳,景日泽.县域医共体支付机制重构的国际经验及启示[J].卫生经济研究,2026,43(09):6-10.
　PAN Di,ZHAO Yang,JING Rize.International Experience and Implications of Payment Mechanism Reconstruction in County-Level Medical Communities[J].Journal Press of Health Economics Research,2026,43(09):6-10.
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县域医共体支付机制重构的国际经验及启示

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
43
期数:
2026年09期
页码:
6-10
栏目:
专题研究：县域医共体
出版日期:
2026-09-02

文章信息/Info

Title:
International Experience and Implications of Payment Mechanism Reconstruction in County-Level Medical Communities
作者:
潘 迪1; 赵 阳2; 景日泽3
1.浙江省人民医院（附属人民医院），杭州医学院，浙江 杭州 310014
2.中国人民大学公共管理学院，北京 100872
3.中国人民大学人口与健康学院，中国人民大学北京人口发展与治理研究创新中心，北京 100872
Author(s):
PAN Di;  ZHAO Yang;  JING Rize
Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Zhejiang 310014, China
关键词:
县域医共体; 基层健康管理; 国际经验
Keywords:
county-level medical communities;  primary health management;  international experience
分类号:
R197
文献标志码:
A
摘要:
当前，我国县域医共体建设已从组织整合和资源下沉阶段进入机制完善和功能提升阶段，如何推动服务体系从“以疾病治疗为中心”转向“以健康为中心”，已成为亟须明确的重要问题。在此过程中，县域医共体支付面临现实困境：基层健康责任缺乏有效支付、多元资金缺乏统筹、县乡利益联动不足、绩效考核偏重过程指标，等等。对此，可借鉴英国、美国、澳大利亚的基层健康管理机制建设经验，探索购买基层承担的居民健康责任，构建健康责任购买、风险共担、结果评价、能力补偿“四位一体”制度，为实现医共体向健共体的深度转型提供政策依据。
Abstract:
Currently, the construction of county-level medical communities in China has transitioned from the stage of organizational integration and resource allocation to the stage of mechanism refinement and functional enhancement. How to promote the transformation of the service system from "disease treatment-centered" to "health-centered" has become a critical issue that needs urgent clarification. In this process, payment mechanisms for county-level medical communities face practical challenges, including ineffective payment for primary health responsibilities, lack of coordination among multiple funding sources, insufficient county-township interest linkage, and performance assessment biased toward process indicators. In response, drawing on the experience of primary health management mechanisms in the United Kingdom, the United States, and Australia, this study explored the purchase of health responsibilities undertaken by primary-level institutions, and proposed a four-in-one institutional framework of health responsibility purchase, risk sharing, outcome evaluation, and capacity compensation, providing policy references for achieving the deep transformation from medical communities to health communities.

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更新日期/Last Update: 2026-09-02