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该文依据卫生系统宏观模型思路 ,应用层次分析法 ,逻辑推论了疾病防制系统焦点问题 (疾病防制功能难以切实落实到位 )的直接相关因素和间接促发因素 ,认为问题的起始根源是政府对公共产品提供机构的财政投入不足 ,致使疾病防制功能中无偿服务部分缺乏激励监督 ,同时为了弥补财政投入的不足政府不得不允许疾病防制机构提供部分“有偿服务”但缺乏有效的规范和制约 ,导致功能偏废 (重有偿轻无偿 ) ,部分缺乏收益的疾病防制功能难以切实落实。并总结和建立了焦点问题的作用机制模型 -“社会互动 :我国疾病防制功能难以切实落实到位作用机制模型”。在此基础上 ,推论了农村三级卫生网及其组织的变化对农村疾病防制功能落实的影响
Based on the idea of the macro model of the health system, this paper applies the analytic hierarchy process to logically infer the direct and related factors that focus on the disease prevention system (difficulty in the effective implementation of disease prevention and control functions), and believe that the origin of the problem is The lack of financial input from the government to institutions providing public goods results in lack of incentives and supervision for the unpaid service component of the disease prevention function. At the same time, in order to make up for the lack of financial input, the government has to allow disease prevention agencies to provide some “paid services” but lacks effective regulations. Constraints have led to the dislocation of functions (paying heavily for free), and the lack of profitable disease prevention and control functions can hardly be implemented. And summed up and established the focal mechanism model of the role of the problem - “social interaction: China’s disease control function is difficult to effectively implement the role mechanism model in place.” On this basis, the impact of changes in rural tertiary health nets and their organizations on the implementation of rural disease prevention and control functions was deduced.