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本文从融资体系、服务体系、管理与监督体系及人力资源输送体系四方面对古巴医疗卫生体系进行了再审视,着重分析了系统有效运行的前提和隐含的问题,并对支撑医疗卫生体系建立与发展的社会背景与政治根源进行了反思。最终从扩大医疗卫生资源和控制医疗卫生服务成本两方面总结了可供借鉴的经验:明确政府责任与主导地位,保障投入比例;优化医疗卫生体系层次结构和资源流向;协调四大子系统的互促与对接关系,形成良性循环;从医疗教育入手引导卫生资源均衡配置;切断医务人员收入与服务费用之间的利益链条从而控制费用膨胀。
This article reviews the health care system in Cuba from four aspects: the financing system, the service system, the management and supervision system and the human resources delivery system. The paper emphatically analyzes the preconditions and hidden problems of the effective operation of the system, Reflections on the social background and political origins of development. Finally, it summarizes the experiences that can be learned from expanding the resources of medical and health care and controlling the cost of medical and health services: clarifying the responsibility and dominance of government, guaranteeing the proportion of investment, optimizing the hierarchy of medical and healthcare systems and the flow of resources, coordinating each other Promote the docking relationship, forming a virtuous circle; from the medical education to guide the balanced allocation of health resources; cut off the medical staff income and service costs between the chain of interest in order to control the cost of inflation.