【摘要】 自1968年以来，中国的赤脚医生制度为8亿农村人口提供基本医疗和公共卫生服务，促进了农村地区全民健康覆盖的实现。聚焦赤脚医生时代的国家健康治理逻辑，基于来自中国不同地区的62位赤脚医生的深度访谈资料，采用扎根理论方法进行编码分析，构建了中国特色全民健康覆盖实现路径的理论模型。研究发现，毛泽东卫生健康思想、政策驱动、价值驱动、制度建设、职业精神、财政保护、服务覆盖、全民参与以及环境因素构成全民健康覆盖实现路径的整体框架。这些要素互动的内在机理揭示了政策驱动和价值驱动下实现全民健康覆盖的双重路径：政策驱动通过推动制度建设提供外部保障，价值驱动通过塑造职业精神激发内生动力。两条路径存在着紧密的相互作用，在“政策—价值”耦合作用下，形成了具有中国特色的全民健康覆盖制度逻辑。基于此，强化初级卫生保健体系、提升基层卫生人员内生动力，并促进政策与价值的耦合，是推进全民健康覆盖的重要方向。更多还原

【Abstract】 Since 1968,China’s barefoot doctor system has provided basic medical and public health services to 800 million rural population, facilitating the realization of universal health coverage in rural areas.This study focuses on the national health governance logic during the era of barefoot doctors, employs grounded theory for coding and analysis based on in-depth interviews with 62 barefoot doctors from different regions of China and constructs a theoretical model of pathways to achieving universal health coverage with Chinese characteristics.The findings show that Mao Zedong thought on health, policy-driven, value-driven, institutional construction, professionalism, financial protection, service coverage, universal participation, and environmental factors constitute the overall framework for achieving universal health coverage The intrinsic mechanism of interaction among these elements reveals the dual path to achieving universal health coverage driven by policy and value: policy-driven offers external support by advancing institutional construction and value-driven stimulates endogenous motivation by shaping professionalism.Moreover, these two pathways also interact closely, and the coupling between policy and values forms the institutional logic of universal health coverage with Chinese characteristics.Strengthening primary healthcare systems, enhancing the intrinsic motivation of primary health workers, and promoting the coupling between policies and values represent important directions for advancing universal health coverage.更多还原