多元视角下对我国医改顶层设计的再思考 ——以第一批县级公立医院综合改革试点改革评估为例

在医药卫生领域，改革是一项涉及到多方利益、需要多部门配合才能有效推进的综合改革。就我国医药卫生体制改革目前的发展情况而言，医改过程中出现的问题与各相关部门尚未完善配套的政策支持，以及省级和市级层面的地方方案存在空白与漏洞有着直接关系。因此，我国医药卫生体制改革的顶层设计应该体现一种多元化的全面设计理念。

Rethinking of Top-level Design of Medical and Health Reform in China Under Multi-perspective: Taking Comprehensive Reform Pilot Appraisal of the First Branch of County-level Public Hospitals Appraisal as an Example

In medicine and health field, the reform is a comprehensive reform related to multi-stakeholder, which could be effectively promote with multi-sectoral collaboration. Currently, problems happen because there is no perfect matching of policy support of relevant departments, as well as gaps and vulnerabilities in provincial and municipal levels. Therefore, top-level design of the medical and health system reform should reflect a wide range of comprehensive design philosophy.