【摘要】 文章总结了我国初级卫生保健体系的形成过程,指出初级卫生保健体系建设从自上而下建立卫生机构、保证卫生服务可得性为起点,以逐步发展适宜卫生人力和适宜技术为特点,结合农业合作化运动,依托集体经济建立了合作医疗制度,最终基本解决了卫生服务可及性问题。文章进一步分析了初级卫生保健的成功因素,指出集权制度、社区组织和集体经济是初级卫生保健体系成功运作的重要外部制度条件;同时分析了初级卫生保健体系本身的制度安排,指出与当时社会环境和生产劳动相契合的初级卫生保健运行机制是保证初级卫生保健成功的内部原因。文章同时指出,初级卫生保健体系的内部制度安排是依赖于外部制度因素的,一旦外部制度因素变化,初级卫生保健体系将面临较大的挑战。更多还原

【Abstract】 The formation of primary health care in China was discussed. Firstly, primary health care institutes were established by a top-down model to assure health service attainability. Secondly, suitable health human resource and suitable health technology were continuously developed. Combined with the agricultural cooperation system, the cooperative medical system was built. The external causes of primary health care successful establishing were centralization system, community organization and collective economy. The internal cause was the running mechanism of primary health care which was well matched the macro economic and social environment. Primary health care running mechanism depended on its external institutional arrangement. So once the external environment changed, the primary health care should be frustrated.更多还原