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加强利益相关方在卫生人力治理中的参与:为什么我们需要讨论权力。

Strengthening stakeholder involvement in health workforce governance: why we need to talk about power.

机构信息

1 Senior Researcher, Institute for Economics, Labour and Culture, Goethe-University Frankfurt, Germany.

2 Medical Management Centre, LIME, Karolinska Institutet, Sweden.

出版信息

J Health Serv Res Policy. 2018 Jan;23(1):66-68. doi: 10.1177/1355819617727302. Epub 2017 Oct 19.

Abstract

There is now widespread agreement on the benefits of an integrated, people-centred health workforce, but the implementation of new models is difficult. We argue that we need to think about stakeholders and power, if we want to ensure change in the health workforce. We discuss these issues from a governance perspective and suggest a critical approach to stakeholder involvement as an indicator of good governance. Three models of involving stakeholders in health workforce governance can be identified: corporatist professional involvement either in a continental European model of conservative corporatism or in a Nordic model of public corporatism; managerialist and market-centred involvement of professions as organizational agents; and a more inclusive, network-based involvement of plural professional experts at different levels of governance. The power relations embedded in these models of stakeholder involvement have different effects on capacity building for an integrated health workforce.

摘要

现在人们普遍认同,建立一个综合性的、以人为本的卫生人力队伍具有诸多益处,但要实施新的模式却困难重重。我们认为,如果想要确保卫生人力发生变革,就需要关注利益相关者和权力问题。我们从治理角度探讨了这些问题,并提出了一种批判性的利益相关者参与方法,将其作为良好治理的一个指标。有三种模式可以将利益相关者纳入卫生人力治理:要么让专业人士以社团主义者的身份参与到欧洲大陆式的保守社团主义或北欧式的公共社团主义模式中,要么让专业人士作为组织代理人,以管理主义和以市场为中心的方式参与,要么让不同治理层面的多元化专业专家以更具包容性的网络为基础参与进来。这些利益相关者参与模式中所包含的权力关系对建设综合性卫生人力队伍的能力建设具有不同的影响。

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