Giusti D, Criel B, De Béthune X
Matany Hospital, Moroto District, Uganda.
Health Policy Plan. 1997 Sep;12(3):192-8. doi: 10.1093/heapol/12.3.193.
In most settings, a 'public' health service refers to a service which belongs to the state. The term 'private' is used when health care is delivered by individuals and/or institutions not administered by the state. In this paper it is argued that such a distinction, which is based on the institutional or administrative identity of the health care provider, is not adequate because it takes for granted that the nature of this identity automatically determines the nature of the service delivered to the population. A different frame of classification between public and private health services is proposed: one which is based on the purpose the health service pursues and on the outputs it yields. A set of five operational criteria to distinguish between health services guided by a public or private purpose is presented. This alternative classification is discussed in relation to a variety of existing situations in sub-Saharan Africa (Mali, Uganda, Zimbabwe). It is hoped that it can be used as a tool in the hands of the health planner in order to bring more rationality in the current altercation between the public and the private health care sector.
在大多数情况下，“公共”卫生服务指的是属于国家的服务。当医疗保健由非国家管理的个人和/或机构提供时，使用“私人”一词。本文认为，这种基于医疗保健提供者的机构或行政身份的区分并不充分，因为它理所当然地认为这种身份的性质会自动决定提供给民众的服务的性质。本文提出了一种公共卫生服务和私人卫生服务之间不同的分类框架：一种基于卫生服务所追求的目的及其产生的产出。提出了一套区分以公共目的或私人目的为导向的卫生服务的五项操作标准。结合撒哈拉以南非洲（马里、乌干达、津巴布韦）的各种现有情况对这种替代分类进行了讨论。希望它能成为卫生规划者手中的一种工具，以便在当前公共和私人医疗保健部门的争论中带来更多合理性。
