《农村医疗卫生服务体系建设财政支持问题地研究——以山东省为例》由会员分享，可在线阅读，更多相关《农村医疗卫生服务体系建设财政支持问题地研究——以山东省为例（66页珍藏版）》请在金锄头文库上搜索。
1、山东农业大学硕士学位论文农村医疗卫生服务体系建设的财政支持问题研究-以山东省为 例姓名：孟磊申请学位级别：硕士专业：农业经济管理指导教师：薛兴利2011-05-10“山东农业大学硕士学位论文中 文 摘 要中国是一个发展中的农业大国，“三农”问题是构建社会主义和谐社会的重要组成部分， 没有农业的发展就没有国家的发展，没有农村的稳定就没有国家的稳定”。农村医疗卫生服务体系，作为农村社会保障制度的重要组成部分，对于农村的稳定和经济持续发展尤其具有重要的现实和长远意义，引起国家的高度重视。温家宝总理在第十一届全国人民代表大会第四次会议上的政府工作报告中，把“完成农村三级卫生服务网络和城市社区卫生服务机
2、构建设任务”作为主要任务来抓。不解决好农民的医疗保障问题，就无法实现全面建设小康社会的目标，也不符合构建社会主义和谐社会的要求。本文运用规范与实证分析法、比较分析法、定性与定量分析相结合的方法，选取山东省为典型案例，对农村医疗卫生服务体系建设的财政支持问题进行了较系统的分析。通过分析研究，得出以下主要结论：（1）财政支持在农村医疗卫生服务体系建设中具有重要的作用:一是促进农村医疗卫生服务体系的建立健全；二是提高农村医疗卫生服务质量，更好地保障农民健康；三是减轻农民负担，促进经济发展；四是促进新农村建设，实现社会和谐稳定。（2）总体来说，农村医疗卫生服务体系以县级医疗卫生机构为龙头、乡镇医疗卫生
3、机构为中心、村医疗卫生机构为基础构成。县级医疗卫生机构作为整个服务体系的医疗卫生龙头，主要负责基本医疗服务及危重急症病人的抢救，并承担对乡镇医疗卫生机构、村医疗卫生机构的业务技术指导和卫生人员的进修培训；乡镇医疗卫生机构负责提供公共卫生服务和常见病、多发病的诊疗等综合服务，并承担对村医疗卫生机构的业务管理和技术指导；村医疗卫生机构承担行政村的公共卫生服务及一般疾病的诊治等工作。（3）通过财政支持的不断加强，山东省农村医疗卫生服务体系逐步向完善的方向发展，较好地保障了农民健康，促进了农村社会稳定。但是，山东省农村医疗卫生服务体系建设财政支持依然存在很多问题：一是农村医疗卫生服务体系建设的财政支持
4、比重较小；二是农村医疗卫生服务体系建设的财政支持结构不够合理；三是农村医疗卫生服务体系建设的财政支持的资金运用效率不高。产生这些问题的原因是多方面的，直接原因是财政分权改革使农村医疗卫生服务体系建设的责任偏移；财权与事权不相称，基层财政对农村医疗卫生服务体系建设支出乏力。根本原因是农村医疗卫生服务体系建设的财政支持投入缺乏有力的政策保障；地方政府职能目标的偏离；政府的财政职能转换没I山东农业大学硕士学位论文有到位。深层原因是宏观制度环境的约束。（4）农村医疗卫生服务体系建设中财政支持目标应是完善农村医疗卫生服务体系，健全农村医疗卫生服务网络，使之能够成为广大农民健康水平的有力保障，使之成为社会
5、主义新农村的有力支撑，使之成为构建和谐社会的有生力量。以县级医疗卫生机构为龙头，以乡镇卫生院为中心，以村医疗卫生机构为基础，以农村居民为服务对象，着力加强农村医疗卫生服务体系建设，从根本上提高农民的健康水平。（5）强化农村医疗卫生服务体系建设的财政支持应该在坚持公益性质上的原则下，采取以下措施：一是构建合理完善的地方财政体制；二是优化财政支持资金来源，加大政府财政支持力度；三是建立财政支持资金监管机制，提供资金利用效率；四是统筹城乡卫生资源促进农村医疗卫生服务能力提升；五是充分发挥市场与杜会的力量，积极探索农村卫生服务供给的多元途径。同时，应该完善政府卫生投入立法；制定与农村医疗卫生服务体系建
6、设相配套的政策；努力降低农民就医成本。关键词：农村医疗卫生服务体系；财政支持；政策与措施II山东农业大学硕士学位论文AbstractChina is a developing large agricultural nation, the “three issues concerning farmers“ isan important component of constructing the socialist harmonious society, “ the developmentof agriculture is the basic of national development, th
7、e country is not stable without the ruralstability “. As an important part of the rural stability, rural health service system has aparticularly important realistic and long-term significance for rural social security system andfor sustained economic development, caused the attention of the nation.
8、Premier Wen jiabaoon of the 11th National Peoples Congress on the fourth session of the government workreport, “Complete rural tertiary health service systerm and the urban community healthservice organization construction tasks“ as the main task to grasp. Without the medicalsecurity problems of far
9、mer, it will not be able to achieve the comprehensive constructionaffluent societys goal and to construct a socialist harmonious societys requirements.This paper uses norms and empirical analysis, comparative analysis, combined withqualitative analysis and quantitative analysis method, taking rural
10、health service systemconstruction problems of financial supportf of Shandong Province for instance. Throughanalysis and draw the following main conclusions:(1) Financial support in rural health service system plays an important role in theconstruction of: The first is to promote rural health service
11、 system; The second is to improverural health service quality, better safeguard farmers health; The third is to reduce thefarmers burden, promoting economic development; The fourth is to promote the new ruralconstruction and realize the social harmony and stable(2) Above all, rural health service sy
12、stem contains the county medical institutions as themain item, township health institutions as the center, village health institutions as the based.The county medical institutions as the whole service system health center, are mainlyresponsible for basic medical services and severe diseases and bear
13、 the rescue, patients fortownship, village healthcare agency business of medical and health institutions and medicalpersonnel technical guidance to the education training; Township health institutions areresponsible for providing the public health service and common disease, frequently-occurringdise
14、ase diagnosis and other integrated services, and bear the medical and health institutions ofIII山东农业大学硕士学位论文village business management and technical guidance; Village undertake administrativevillages of medical and health institutions and the general public health services such asdisease treatment.(
15、3) through the strengthening of financial support, shandong province rural medical andhealth service system gradually improve, better security, promoted the farmers health ruralsocial stability. But, financial support for shandong province rural medical and health servicesystem construction still ex
16、ist many problems: The first is the smaller proportion of financialsupport for construction of rural health service system; The second is unreasonable structureof financial support for rural health service system construction; The third is the low capitaloperation efficiency of financial support for rural medical and health service systemconstruction . The reason of causing these problems is various, fiscal decentralization reformis the direct reason; Property and the thing, grassroots dis
