市级政府对属地内委属/省属公立医院的整体性治理研究:基于分级诊疗促进视域OA

At present,multiple levels of government jointly operating public hospitals is an important form of practice in the development of China's hospital system.Within municipal boundaries,the development of hospitals subordinated to health commis-sion or province(higher-level hospitals)often fails to fully align with municipal government planning,exacerbating issues such as the lack of functional positioning and service discontinuity.Based on the geographical distribution and development practices of public hospitals in China,the theoretical rationale underpinning municipal governments'holistic governance of higher-level pub-lic hospitals within their jurisdictions was examined,within the perspective of hierarchical healthcare.Drawing on the dynamics of the vertical-horizontal relationship,the challenges currently faced by municipal governments in governing higher-level public hospitals within their jurisdictions were analyzed,and strategies to enhance holistic governance were proposed.The findings facili-tate the transition from competitive-cooperative dynamics to integrated development between higher-level hospitals and metropol-itan hospital systems,thereby improving the irrational tiered provision of healthcare services under the multi-level affiliation and management structures of public hospitals.