【摘要】：非法行醫(yī)不僅威脅到人民群眾的生命安全,而且擾亂了醫(yī)療衛(wèi)生市場秩序。如何在當(dāng)前全面深化醫(yī)療體系改革新形勢下破解非法行醫(yī)問題,已成為擺在衛(wèi)生監(jiān)管部門面前亟需解決的難題。近年來,隨著閩侯縣經(jīng)濟社會的發(fā)展和福州市城市的快速擴張,與福州市相臨的閩侯縣外來人口增長迅速,醫(yī)療需求激增,導(dǎo)致醫(yī)療資源緊張加劇,使得本來就長期存在、成本低廉的閩侯縣非法行醫(yī)現(xiàn)象滋生漫延,形勢嚴(yán)峻。本文運用公共選擇理論和公共治理理論,通過文獻(xiàn)研究、半結(jié)構(gòu)式訪談、問卷調(diào)查等方法,對閩侯縣近三年非法行醫(yī)案件、閩侯縣居民對非法行醫(yī)的認(rèn)知和態(tài)度等進(jìn)行調(diào)查,深入分析探討閩侯縣非法行醫(yī)存在的原因。主要原因包括:一是非法行醫(yī)有存在的市場空間,如部分民眾缺乏衛(wèi)生常識,對非法行醫(yī)危害認(rèn)識不足;非法行醫(yī)某種程度上迎合了部分患者的需求;非法行醫(yī)利潤可觀,違法成本低。二是現(xiàn)行的醫(yī)療衛(wèi)生體制不完善,如醫(yī)療資源分配不均;醫(yī)療保障體系不完善;部分醫(yī)療衛(wèi)生法律法規(guī)不健全。三是非法行醫(yī)治理難度大,如非法行醫(yī)行為日趨隱蔽,執(zhí)法難度大;"互聯(lián)網(wǎng)+"新形勢下,非法行醫(yī)形成新特點;衛(wèi)生監(jiān)督監(jiān)管任務(wù)重,人員配備不足;職能部門聯(lián)動缺乏,未能形成合力等。論文結(jié)合閩侯縣深化醫(yī)療體系改革新形勢,提出建立加強監(jiān)管、規(guī)范治理非法行醫(yī)的長效機制。一是壓縮非法行醫(yī)存在市場空間。加大宣傳,普及衛(wèi)生常識及法律法規(guī);加強城郊結(jié)合部租賃住房管理;拓寬舉報渠道,形成全社會共治非法行醫(yī)格局。二是深化醫(yī)療體制改革。優(yōu)化醫(yī)療資源配置,加強基層醫(yī)療衛(wèi)生建設(shè);建立完善的醫(yī)療保障體系;完善醫(yī)療衛(wèi)生法律法規(guī),增強可執(zhí)行力。三是加大非法行醫(yī)監(jiān)管力度。加大非法行醫(yī)整治力度,創(chuàng)新非法行醫(yī)治理模式;規(guī)范"互聯(lián)網(wǎng)+"移動醫(yī)療,填補監(jiān)管空白;加強監(jiān)督隊伍建設(shè),提升執(zhí)法水平;完善多部門聯(lián)動機制,綜合治理非法行醫(yī)。通過疏堵結(jié)合,破解當(dāng)前閩侯縣非法行醫(yī)困局,維護(hù)閩侯縣醫(yī)療市場秩序,營造良好醫(yī)療環(huán)境,保障廣大民眾的的身心健康和合法權(quán)益。
[Abstract]:Illegal practice of medicine not only threatens the lives of people, but also disturbs the order of medical and health market. How to solve the problem of illegal medical practice under the new situation of deepening the reform of medical system in an all-round way has become a difficult problem that needs to be solved in front of the health supervision department. In recent years, with the economic and social development of Minhou County and the rapid expansion of the city of Fuzhou, the population of Minhou County, which is adjacent to Fuzhou, has grown rapidly and the medical demand has increased sharply, leading to an increase in the shortage of medical resources, which has long existed. The low-cost Minhou County illegal medical practice phenomenon breeding spread, the situation is grim. Based on the theory of public choice and public governance, this paper investigates the cases of illegal practice of medicine in Minhou County in the past three years, and the cognition and attitude of residents of Minhou County on illegal practice of medicine by means of literature research, semi-structured interviews and questionnaires. The causes of illegal medical practice in Minhou County were analyzed. The main reasons include: first, there is a market space for illegal practice of medicine, such as the lack of common sense of hygiene among some people, the lack of understanding of the harm of illegal practice of medicine, the illegal practice of medicine to some extent meet the needs of some patients; The profit of illegal medical practice is considerable and the illegal cost is low. Second, the current medical and health system is not perfect, such as uneven distribution of medical resources; medical security system is not perfect; some health laws and regulations are not perfect. Third, illegal medical practice is difficult to manage, such as illegal medical practice is becoming more and more covert, law enforcement is difficult; under the new situation of "Internet", illegal medical practice forms new characteristics, health supervision and supervision task is heavy, and personnel is insufficient; Lack of linkage of functional departments, failure to form joint forces and so on. According to the new situation of deepening the reform of medical system in Minhou County, this paper puts forward the long-term mechanism of strengthening supervision and regulating illegal practice of medicine. First, compressed illegal practice of medicine exists in the market space. Increase publicity, popularize general knowledge of hygiene and laws and regulations, strengthen the management of rental housing in the suburbs, widen the reporting channels, and form a pattern of social co-treatment of illegal medical practice. Second, deepen the reform of the medical system. We should optimize the allocation of medical resources, strengthen the construction of primary medical and health care, establish a sound medical security system, perfect the laws and regulations of medical and health care, and enhance the ability of execution. Third, strengthen the supervision of illegal practice of medicine. Strengthen illegal medical treatment, innovation illegal medical treatment mode; standardize "Internet" mobile medical treatment, fill in regulatory gaps; strengthen the construction of supervision team, improve the level of law enforcement; improve the multi-sector linkage mechanism, comprehensive control of illegal medical practice. In order to solve the difficult situation of illegal medical practice in Minhou County, maintain the order of medical market in Minhou County, create a good medical environment, and ensure the physical and mental health and legitimate rights and interests of the masses.
【學(xué)位授予單位】：福建農(nóng)林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197

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