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签而不约:家庭医生签约服务政策为何阻滞 预览 被引量:8

Signed Without Agreement: Why Family Doctor Service Policy Hindered
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摘要 自政府推行家庭医生签约服务政策以来全国各地形成了五种经验模式,但是各地不同程度地存在着签约率虚高现象,居民对家庭医生签约服务的知晓率不高,即便是签约居民,其家庭医生服务项目利用率也不高,出现了政策供给与政策享用之间的阻滞。这种签而不约现象运用西方公共政策执行过程理论、系统理论、博弈理论以及科层制理论并不能很好地解释这一难题。这就需要考察家庭医生签约服务政策签而不约产生的情境与结构因素,强调政治与文化情境、利益与社会结构等因素导致家庭医生签约服务签而不约。一项政策能否顺利执行不仅在于政策本身是否科学合理可行,更在于是否具备一定的情境与结构因素,政策执行的结构与情境构成了解释中国公共政策执行的一把钥匙。 Since the government promoted the Family Doctor's Signing Service policy, five kinds of experience models have been established throughout the country. various parts of the country. The degree of residents' However, there air various degrees of signing ratios in awareness of family doctor services are relatively low, even if they have already signed up. Residents of family doctors also have low utilization of family doctor services and there are obstacles between policy supply and enjoyment. In order to explain this phenomenon, West- ern public policy implementation process theory, system theory, game theory, and bureaucratic theory do not work. Therefore, it is necessary to examine the situational and structural factors arising from the signing of the family doctor's signing service policy, emphasizing that factors such as political and cultural situations, interests, and social structure leading to signing service contracts for family doctors. Whether or not policy can be implement smoothly depends not only the policy itself is scientific, reasonable, and feasible, but also it has certain contextual and structural factors. The structure and context of policy implementation constitutes a key to explaining the implementation of China's public policy.
作者 高和荣 GAO He-rong ( School of Public Affairs, Xiamen University,Xiamen 361005, China)
出处 《西北大学学报:哲学社会科学版》 CSSCI 北大核心 2018年第3期48-55,共8页 Journal of Northwest University(Philosophy and Social Sciences Edition)
基金 2015年国家社会科学基金重点项目(15AZD023)阶段性成果
关键词 家庭医生签约服务 政策执行结构 政策执行情境 family doctor service policy implementation structure policy implementation context
作者简介 高和荣,男,江苏兴化人,厦门大学教授,台湾研究院兼职教授,博士生导师,从事社会保障、社会政策研究。
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