"三医"协同治理的底层逻辑与政策机制研究OA

Healthcare system reform remains a global challenge.China's healthcare reform has transitioned from"Three-Medical Linkage"to a new phase of"Three-Medical Coordination",integrating industrial and public service policies to safeguard the"Healthy China"initiative.Utilizing the"Lü-Ling-Ge-Shi"(statutes-decrees-norms-modalities)framework,this paper constructs a four-dimensional governance model of"Target-Instrument-Organization-Evaluation"to analyze its institutional configuration.Research has shown that pharmaceutical and healthcare industrial policies have achieved remarkable results in supporting innovation,while the medical sector is undergoing a profound transformation from scale expansion to connotation-oriented development.Driven by multiple policy orientations such as payment reform,centralized procurement,and medical insurance fund supervision,medical institutions face complex adjustment pressures in controlling costs,improving service quality,and safeguarding public welfare.Constrained by the lag in supporting mechanisms,some institutions have exhibited adaptive deviations in policy implementation.This creates a supply-demand mismatch characterized by"strong incentive constraints and weak supply adaptation",particularly evident in Diagnosis-Related Groups(DRG)and Big Data Diagnosis-Intervention Packet(DIP)expansions and the development of county-level medical communities.To optimize overall social welfare,the reform must center on incentive compatibility.A central-provincial-county implementation mechanism is needed to institutionalize policy coordination,information connectivity,and regulatory linkage.This study provides theoretical and practical support for the"Three-Medical Coordination"governance model.