冯占春：博士，二级教授，博士研究生导师。现任华中科技大学同济医学院医药卫生管理学院院长，湖北省卫生经济学会会长，湖北省重点人文社科基地农村健康服务研究中心主任，湖北省卫生技术评估研究中心主任，武汉市医学伦理专家委员会主任委员，华中科技大学同济医学教育研究所执行所长，华中科技大学智慧健康研究院执行院长。先后主持国家重点研发计划项目1项，国家自然科学基金7项，科技部重大专项子课题2项，省部级课题30余项；发表SCI/SSCI论文50余篇，中文论文300余篇，出版专著和教材近10部。先后获得湖北省科技进步奖、中华医学科技奖卫生管理奖和武汉市科技进步奖等多个奖项。熊巨洋：管理学博士，副教授，博士/硕士研究生导师，美国哥伦比亚大学访问学者。华中科技大学同济医学院医药卫生管理学院MPA教育中心主任。主要从事慢性病服务与管理、长期护理保险政策、健康偏好与行为经济学、中医药管理与政策等教学及科研工作。主持国家自然科学基金面上项目、*人文社科基金一般项目、国家中医药局重大项目等课题20余项，在Social Science and Medicine、PLoS Medicine、BMJ Open、BMC Health Service Research、Patient Preference and Adherence、Arch Public Health、人口与发展、中华医院管理杂志、中国卫生政策研究、中国卫生经济等核心期刊发表学术论文100余篇；出版专著2部，主编留学生教材1部，参编著作及教材8部，获得省部级科技进步奖7项，教育教学奖励13项（次）。在中国医师协会人文管理分会、中华中医药协会人文与管理分会、中国医药生物技术协会卫生技术评估专委会、湖北省老年保健协会等多个社会组织任职。
目錄：
1中国卫生体系概况0011.1中国卫生体系背景0011.2中国卫生体系基本构成0021.3中国卫生体系发展历程0082中国的卫生工作方针与健康中国行动0122.1中国的卫生工作方针0122.2健康中国行动0163中国医疗服务体系0213.1中国医疗服务体系概况0213.2中国各级医疗服务现状及发展方向0243.3中国医疗服务体系的高质量发展0284中国公共卫生管理体系和公共卫生服务体系0314.1中国公共卫生管理体系0314.2中国公共卫生服务体系0345中国医疗保障体系0425.1城镇职工基本医疗保险0435.2城乡居民基本医疗保险0455.3城乡医疗救助、商业医疗保险与补充医疗保险0506中国药品供应保障体系0546.1中国药品供应保障组织体系0546.2中国药品供应保障管理体系0596.3中国国家基本药物制度0617中医药服务与管理0647.1中医药服务0647.2中医药管理0698中国卫生资源规划0738.1中国卫生资源规划概述0738.2中国卫生资源规划的制定0769中国卫生筹资与卫生总费用0839.1中国卫生筹资0839.2中国卫生资金的分配和使用0869.3卫生总费用09010中国医药卫生法律制度与监督管理09410.1中国医药卫生法律制度概述09410.2中国医药卫生法律制度的主要构成09610.3中国医药卫生监督管理09911中国医药卫生信息体系10411.1医药卫生信息系统的重要性10411.2中国医药卫生信息化发展状况10611.3中国医药卫生信息管理体系1091 Overview of China’s Health System1131.1 Background of China’s Health System1131.2 The Basic Composition of China’s Health System1151.3 Development of China’s Health System1252 China’s Health Work Guidelines and the Healthy China Initiative1322.1 China’s Health Work Guidelines1322.2 The Healthy China Initiative1393 China’s Medical Service System1463.1 Overview of China’s Medical Service System1463.2 The Current Situation and Development Direction of China’s Medical Services at All Levels1523.3 HighQuality Development of China’s Medical Service System1574 China’s Public Health Management System and Public Health Service System1624.1 China’s Public Health Management System1624.2 China’s Public Health Service System1675 China’s Medical Security System1815.1 Basic Medical Insurance for Urban Employees1825.2 Basic Medical Insurance for Rural and NonWorking Urban Residents1875.3 Urban and Rural Medical Assistance，Commercial Medical Insurance，and Supplementary Medical Insurance1966 China’s Drug Supply Guarantee System2036.1 China’s Drug Supply Guarantee Organization System2036.2 China’s Drug Supply Guarantee Management System2116.3 China’s National Essential Medicine System2147TCM Services and Management2207.1 TCM Services2207.2 TCM Management2308 China’s Health Resource Planning2368.1 Overview of China’s Health Resource Planning2368.2 Formulation of China’s Health Resource Planning2419 Health Financing and Total Health Expenditure in China2529.1 Health Financing in China2529.2 Allocation and Utilization of Health Funds in China2559.3 Total Health Expenditure26210 Legal System and Supervision of Medicine and Health in China26710.1 Overview of China’s Legal System for Medicine and Health26710.2 Main Components of China’s Legal System for Medicine and Health27110.3 Medicine and Health Supervision and Management in China27611 China’s Medical and Health Information System28511.1 The Importance of the Medical and Health Information System28511.2 Development Status of Medical and Health Informatization in China28911.3 Medical and Health Information Management System in China294参考文献References300
內容試閱：
序言当你们翻开“发现中国系列”之《中国卫生（双语版）》时，或许正在思考一个深刻的问题：如何让一个拥有14亿多人口的发展中国家，在有限的资源条件下，实现人人享有基本卫生保健服务？这正是中国医疗卫生体制改革（以下简称“中国医改”）向世界贡献的中国智慧。作为这场改革的亲历者和参与者，我们很荣幸能通过本书，与全球特别是发展中国家的同仁分享我们的实践与思考。中国医改不是实验室里的理想模型，而是一场在广袤土地上展开的民生实践。2009年新医改启动时，中国面临着城乡差距大、资源分布不均、传染病与慢性病双重负担等典型的发展中国家困境。但通过10余年的探索，中国构建了全球最大的基本医疗保障网，居民个人卫生支出占比从2012年的34.34%下降到2021年的27.60%，人均预期寿命从2011 年的74.8 岁增长到2021年的78.2 岁。这些数字背后凝结着五项关键的经验。以公平性统领制度设计 中国医改强势破解城乡二元结构，将新型农村合作医疗制度与城镇居民基本医疗保险制度整合为统一的城乡居民基本医疗保险制度；截至2023年底，基本医疗保险参保人数约为13.34亿人，参保覆盖面稳定在95%以上。中央财政对中西部地区的专项补助，使*偏远的山村也能享有基本医疗服务。这种“托底式公平”，让健康权成了*普惠的民生福祉。用基层网络筑牢健康防线 截至2021年底，中国90%的城乡居民15分钟内可到达*近医疗点。这不是依靠兴建超级医院，而是通过“县乡村一体化”机制，让3.5万个乡镇卫生院和59.9万个村卫生室成为“健康守门人”。基层首诊、双向转诊的分级诊疗模式，使大医院门诊量降低，县域内就诊率超过90%。让预防优于治疗成为国家行动 中国建立了全球最大的传染病网络直报系统及疾病和健康危险因素监测网络，将高血压、糖尿病、慢性阻塞性肺疾病等慢性病管理纳入国家基本公共卫生服务。爱国卫生运动从“除四害”升级为健康城市创建，例如这一举措有效降低了江苏启东这一肝癌高发区的肝癌发病率。以技术创新破解资源瓶颈 通过“互联网 医疗健康”，三甲医院专家可实时指导5 000千米外的新疆乡村医生的诊疗工作。中国积极推广人工智能辅助诊断系统，并在部分贫困县试点应用，有效降低了基层误诊率。中药配方颗粒技术让传统验方走进现代药房，惠及广大的慢性病患者。用制度创新激发系统活力 福建三明的“三医联动”改革证明，医疗、医保、医药协同改革，可以在不增加财政负担的前提下实现服务质量提升。这种改革智慧正在转化为国家层面的支付方式改革和药品集中带量采购制度，为患者节约费用超过千亿元。当然，中国医改仍在路上。老龄化社会的“银发浪潮”、疾病谱系的深刻变化、群众对优质医疗的更高期待，都在催生着新的变革。但我们坚信，只要坚守“以人民健康为中心”的初心，任何挑战都将转化为进步的阶梯。对于发展中国家同仁，中国经验的核心启示在于：健康治理没有放之四海而皆准的模板，但存在普遍的价值坐标——将健康视为社会投资而非消耗性支出，将制度优势转化为资源整合能力，用适宜技术架起理想与现实的桥梁。例如，中非“光明行”活动在津巴布韦、马拉维、莫桑比克等多国相继开展，为2 000多名非洲白内障患者带来光明；同时，中国与东盟国家签订的首个人工智能合作创新平台落地老挝。这些实践生动展现了全球健康治理中的东方智慧。期待本书能成为一把钥匙，为读者开启理解中国医改的大门，更期盼各国读者从中获得启迪，共同谱写人类健康事业的新篇章。2025年2月27日于武汉PrefaceWhen you open China’s Health System(Bilingual Edition) of “Introduction to China’s S&T Innovation， ” you might be pondering a profound question: How can a developing country with a population of over 1.4 billion achieve universal access to basic health care services under limited resources? This is precisely the Chinese wisdom that China’s medical and health system reform has contributed to the world. As witnesses and participants in this reform， we are honored to share our practices and reflections with global peers， especially those from developing countries， through this book.China’s medical and health system reform is not an ideal model conceived in a laboratory but a practical endeavor unfolding across a vast land. When the new medical reform was launched in 2009， China faced typical challenges of developing countries， such as significant urbanrural disparities， uneven resource distribution， and the dual burden of infectious and chronic diseases. However， through over a decade of exploration， China has built the world’s largest basic medical insurance network. The proportion of personal health expenditure dropped from 34.34% in 2012 to 27.60% in 2021， and the average life expectancy increased from 74.8 years in 2011 to 78.2 years in 2021. Behind these figures lie five key experiences.Prioritizing equity in system design China’s medical and health system reform has vigorously addressed the urbanrural dual structure by integrating the new rural cooperative medical care system with the basic medical insurance system for nonworking urban residents into a unified basic medical insurance system for rural and nonworking urban residents. By the end of 2023， the number of people covered by basic medical insurance reached approximately 1.33 billion， with a coverage rate stable at over 95%. Central government subsidies to central and western regions ensure that even the most remote villages have access to basic medical services. This “bottomline equity” approach has made the right to health a universal benefit.Strengthening health defenses with grassroots networks By the end of 2021， 90% of urban and rural residents in China could reach the nearest medical facility within 15 minutes. This was achieved not by building super hospitals but through a “countytownshipvillage integration” mechanism， turning 35 000 township health centers and 599 000 village clinics into “health gatekeepers.” The hierarchical diagnosis and treatment model， featuring primary care first diagnosis and twoway referrals， has reduced outpatient visits to large hospitals， with over 90% of patients treated within their counties.Making prevention a national priority China has established the world’s largest direct reporting system for infectious disease epidemics and a monitoring network for diseases and health risk factors. Chronic diseases such as hypertension， diabetes， and chronic obstructive pulmonary disease have been incorporated into the national basic public health services. The Patriotic Health Campaign has evolved from the Elimination of the Four Pests to the creation of healthy cities.For example，this initiative has effectively reduced the incidence of liver cancer in Qidong， Jiangsu Province—a region previously known as a highrisk area for liver cancer.Breaking resource bottlenecks with technological innovation Through “Internet Healthcare，” experts from GradeA tertiary hospitals can guide rural doctors in Xinjiang， 5 000 kilometers away， in real time. China has actively promoted AIassisted diagnostic systems， and piloted their use in some impoverished counties， effectively reducing misdiagnosis rates at the grassroots level. Traditional Chinese medicine formula granule technology has brought ancient prescriptions into modern pharmacies， benefiting a vast number of chronic disease patients.Inspiring systemic vitality through institutional innovation The “Triple Linkage” reform in Sanming， Fujian Province， demonstrates that coordinated reforms in health care， medical insurance， and medicine can improve service quality without increasing financial burdens. This reform wisdom is now being translated into nationallevel payment reforms and centralized drug bulkbuying systems， saving patients over 100 billion yuan.Of course， China’s medical and health system reform is still ongoing. The “silver wave” of an aging society， profound changes in disease patterns， and higher public expectations for quality health care are all driving new transformations. However， we firmly believe that as long as we adhere to the principle of “putting people’s health at the center，” any challenge can become a stepping stone to progress.For our peers in developing countries， the core lesson from China’s experience is that there is no onesizefitsall template for health governance， but there are universal values: treating health as a social investment rather than a consumptive expense， transforming institutional advantages into resource integration capabilities， and bridging ideals and reality with appropriate technologies. For example， the Chinese Brightness Action in Africa has been carried out in Zimbabwe， Malawi， Mozambique， and other countries， restoring sight to over 2 000 African cataract patients. Meanwhile， the first AI cooperation and innovation platform between China and ASEAN countries has been established in Laos. These practices vividly demonstrate the Eastern wisdom in global health governance.We hope this book will serve as a key to unlocking the door to understanding China’s medical and health system reform for its readers. Furthermore， we hope that readers from around the world will gain inspiration from it and work together to write a new chapter in the advancement of global health and wellbeing.Written in Wuhan on February 27， 2025
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