公立和私立醫療機構合作提供醫療衛生服務策略的描述性系統評價_《中國循證醫學雜志》

作者：

劉琴 , 王宏 , 李蕾 , 張帆 , 李鵑 , 宋文豐 , 劉惠 ,  汪洋

重慶醫科大學公共衛生學院（重慶?400016）;

關鍵詞：

公立醫療機構私立醫療機構公私合作伙伴關系衛生服務系統評價

DOI：

10.7507/1672-2531.20090092

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　全面評價公立和私立醫療機構合作提供醫療衛生服務的策略。
方法　檢索19個電子數據庫和3個灰色文獻數據庫截止至2008年9月收錄的文獻，并檢索了9個相關機構網站和Google搜索引擎以彌補數據庫的遺漏。納入所有描述或評價公立和私立醫療機構合作提供醫療衛生服務策略的文獻。由兩名研究者獨立進行文獻篩查、質量評價及資料提取。對質量評分為A級和B級的研究進行最后的綜合分析。
結果　共納入38篇文獻，其中22篇描述策略，16篇評價策略。醫療衛生服務對象主要包括結核病患者、艾滋病患者、精神病患者、社區居民和兒童等人群。公私合作伙伴關系主要有六種方式：① 正式或非正式協議；② 工作組委員會；③ 督導培訓和監管；④ 支持資助；⑤ 醫療衛生服務組織的整合；⑥ 公私同址。評價公私合作策略的研究大部分為觀察性研究，僅有3篇是干預前后對照研究。絕大多數研究結果顯示，公私合作伙伴關系對醫療衛生服務的提供有積極的促進作用，同時也面臨許多問題與挑戰。
結論　現有研究表明公立與私立醫療機構合作對醫療衛生服務的提供能起到一定的促進作用。但目前公私合作提供醫療衛生服務的領域和研究深度有限，尚缺乏設計嚴謹的評價性研究。策略實施的效果與其相應的實施背景密切相關，因此需要結合中國的實際情況對目前實施較為成功的公私合作策略選擇性地借鑒。

引用本文： 劉琴,王宏,李蕾,張帆,李鵑,宋文豐,劉惠,汪洋. 公立和私立醫療機構合作提供醫療衛生服務策略的描述性系統評價. 中國循證醫學雜志, 2009, 09(5): 492-502. doi: 10.7507/1672-2531.20090092 復制

1.	Involving private medical practitioners in TB and STI control, Report of an Informal Consultation Bangkok, World Health Organization Regional Office for South-East Asia, 2001. (7). Available from: URL: http://www.searo.who.int/LinkFiles/AIDS_tb-235.pdf.
2.	Forging Partnerships - With Private Health Sector. Available from: URL: http://www.searo.who.int/LinkFiles/Tuberculosis_left32.pdf.
3.	于廣軍, 高解春. 公立醫院改革的國際比較研究, 中國醫院院長, 2007, 9: 39-42.
4.	Huntington D, Sulzbach S. Public Policy and Franchising Reproductive Health: Current Evidence and Future Directions, World Health Organization, 2007.
5.	Dewan PK, Lal SS, Lonnroth K, et al. Improving tuberculosis control through public-private collaboration in India: literature review. British Medical Journal, 2006, 7541(332), 574-577.
6.	張宏. 巴西初級衛生保健的新嘗試, 中國衛生人才, 2007, 11: 38-39.
7.	高光明. 公立與私立醫療機構的劃分, 國外醫學, 醫院管理分冊, 1998, (3): 115-116.
8.	Sheikh K, Porter J, Kielmann K, et al. Public-private partnerships for equity of access to care for tuberculosis and HIV/AIDS: lessons from Pune, India, transactions of transactions of the royal society of tropical medicine and hygiene, 2006, 4(100): 312-320.
9.	Arora VK, Sarin R, Lonnroth K. Feasibility and effectiveness of a public-private mix project for improved TB control in Delhi, India. International Journal of Tuberculosis and Lung Disease, 2003, 12(7): 1131-1138.
10.	Lonnroth K, Thuong LM, Linh PD, et al. Utilization of private and public health-care providers for tuberculosis symptoms in Ho Chi Minh City, Vietnam. Health Policy and Planning, 2001, 1(16): 47-54.
11.	Malmborg R, Mann G, Thomson R, et al. Can public-private collaboration promote tuberculosis case detection among the poor and vulnerable? Bulletin of the World Health Organization, 2006, 9(84):752- 758.
12.	Karki DK, Mirzoev TN, Green NT, et al. Costs of a successful public-private partnership for TB control in an urban setting in Nepal, BMC Public Health, 2007, 84.
13.	Hurtig AK, Pande SB, Baral SC, et al. Linking private and public sectors in tuberculosis treatment in Kathmandu Valley, Nepal. Health Policy and Planning, 2002, 17(1): 78-89.
14.	Newell JN, Pande SB, Bara SC, et al. Control of tuberculosis in an urban setting in Nepal: public–private partnership. Bulletin of the World Health Organization, 2004, 82: 92-98.
15.	Schwartz JB, Bhushan I. Improving immunization equity through a public-private partnership in Cambodia. Bulletin of the World Health Organization, 2004, 82(9): 661-667.
16.	Banda EN, Simukonda HP, et al. The public/private mix in the health care system in Malawi. Health Policy and Planning, 1994, 9(1): 63-71.
17.	Nishtar S, Bile KM, Ahmed A, et al. Process, Rationale, and Interventions of Pakistan’s National Action Plan on Chronic Diseases. Preventing Chronic Disease, 2006, 3: 1.
18.	Quy HT, Lan NTN, Lönnroth K, et al. Public-private mix for improved TB control in Ho Chi Minh City, Vietnam: An assessment of its impact on case detection. International Journal of Tuberculosis and Lung Disease, 2003, 7(5): 464-471.
19.	Raman AV, Björkman JW. Public-private partnership in the provision of health care services to the poor in India. Global Development Network, 2007, 32.
20.	Dewan PK, Lal SS, Lonnroth K, et al. Improving tuberculosis control through public-private collaboration in India: literature review, BMJ, 2006, 332: 574-578.
21.	Annigeri VB, Prosser L, Reynolds J, et al. An assessment of pubic-private partnership opportunities in India. Poptech, 2004.
22.	Sehgal S, Dewan PK, Chauhan LS, et al. Public-Private Mix TB activities in Meerut, Uttar Pradesh, North India: delivering DOTS via collaboration with private providers and non-governmental organizations. Indian J Tuberc, 2007, 54: 79-83.
23.	Kumar MKA, Dewan PK, Nair PKJ, et al. Improved tuberculosis case detection through public-private partnership and laboratory-based surveillance, Kannur District, Kerala, India, 2001-2002. International Journal of Tuberculosis and Lung Disease, 2005, 9(8): 870-876.
24.	Rangana S, Ambeb G, Borremans N, et al. The Mumbai experience in building field level partnerships for DOTS implementation. Tuberculosis, 2003, 83: 165-172.
25.	Arora VK, Sarin R, Lönnroth K. Feasibility and effectiveness of a public-private mix project for improved TB control in Delhi, India. International Journal of Tuberculosis and Lung Disease, 2003, 7(12): 1131-1138.
26.	Murthy KJR, Frieden TR, Yazdani A, et al. Public-private partnership in tuberculosis control: experience in Hyderabad, India. International Journal of Tuberculosis and Lung Diseas, 2001, 5(4): 354-359.
27.	Patel A, Ramani KV, Mavalankar DV, et al. Implementing a Public Private Partnership Model for Managing Urban Health in Ahmedabad. Research and Publications, 2007.
28.	Ramiah I, Reich MR. Building effective public–private partnerships: Experiences and lessons from the African Comprehensive HIV/AIDS Partnerships (ACHAP). Social Science and Medicine, 2006, 63(2): 397-408.
29.	Dreesch N, Nyoni J, Mokopakgosi O, et al. Public-private options for expanding access to human resources for HIV/AIDS in Botswana. BMC Human Resources for Health, 2007, 5: 25.
30.	Ramiah I, Reich MR. Public-private partnerships and antiretroviral drugs for HIV/AIDS: lessons from botswana. Health Affairs, 2005, 24: 2.
31.	Clark P, O’Brien K. Fighting AIDS in Sub-Saharan Africa: is a public--private partnership a viable paradigm? Med Sci Monit, 2003, 9(9), 28-39.
32.	Mantala MJ. Public-private mix DOTS in the Philippines, Tuberculosis, 2003, 83(1-3): 173-176.
33.	Sinanovic E, Kumaranayake L. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa. BMC Cost Effectiveness and Resource Allocation, 2006, 4: 11.
34.	Ardian M, Meokbun E, Siburian L, et al. A public-private partnership for TB control in Timika, Papua Province, Indonesia. International Journal of Tuberculosis and Lung Disease, 2007, 11(10): 1101-1107.
35.	Lönnroth K, Uplekar M, Arora VK, et al. Public-private mix for DOTS implementation: What makes it work? Bulletin of the World Health Organization, 2004, 82: 580-586.
36.	Fisher WH, Dorwart RA, Schlesinger M, et al. Contracting between Public Agencies and Private Psychiatric Inpatient Facilities. Medical Care, 1991, 29(8): 766-774.
37.	Romana HW. Overview of the Community Care Network Demonstration Program and Its Evaluation. Medical Care Research and Review, 2003, 60, 5S.
38.	Morrow H, Collins BK, Smith DR. Public health coalitions: patterns and perceptions in state immunization programs. Jhhsa Fall, 2007: 157-175.
39.	Shortell SM, Zukoski AP, Alexander JA, et al. Evaluating Partnerships for Community Health Improvement: Tracking the Footprints. Journal of Health Politics, Policy and Law, 2002, 27: 1.
40.	Weiner BJ, Alexander J. A The Challenges of Governing Public-Private Community Health Partnerships. Health Care Management, 1998, 23(2): 39-55.
41.	Bazzoli GJ, Stein R, Alexander JA, et al. Public-Private Collaboration in Health and Human Service Delivery: Evidence from Community Partnerships. The Milbank Quarterly, 1997, 75 (4): 533-561.
42.	Pirkis J, Livingston J, Herrman H, et al. Improving collaboration between private psychiatrists, the public mental health sector and general practitioners: evaluation of the Partnership Project. Australian and New Zealand Journal of Psychiatry, 2004, 38: 125-134.
43.	Browna L, Barnett JR. Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia. Social Science & Medicine, 2004, 58: 427-444.
44.	Pirkis J, Herrman H, Schweitzer I, et al. Evaluating complex, collaborative programmes: the Partnership Project as a case study. Australian and New Zealand Journal of Psychiatry, 2001, 35(5): 639-646.
45.	Thaldorf C, Liberman A. Integration of Health Care Organizations Using the Power Strategies of Horizontal and Vertical Integration in Public and Private Health Systems. The Health Care Manager, 2007, 26(2): 116-127.
46.	Malmborg R, Mann G, Thomson R, et al. Can public-private collaboration promote tuberculosis case detection among the poor and vulnerable? Bulletin of the World Health Organization, 2006, 84(9): 752-758.
47.	Patouillard E, Goodman CA, Hanson KG, et al. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature. BMC International Journal for Equity in Health, 2007, 6: 17.
48.	Waters H, Hatt L, Peters D. Working with the private sector for child health, Health. Policy and Planning, 2003, 18(2): 127-137.
49.	Uplekar M, Pathania V, Raviglione M. Involving Private Practitioners in Tuberculosis Control: Issues, Interventions, and Emerging Policy Framework. WHO, 2001, 285.
50.	周成武, 嚴肅勤, 陳建平, 等. 公私合作伙伴關系在衛生領域的應用, 中國衛生經濟, 2006, 25(5): 73-75.

1. Involving private medical practitioners in TB and STI control, Report of an Informal Consultation Bangkok, World Health Organization Regional Office for South-East Asia, 2001. (7). Available from: URL: http://www.searo.who.int/LinkFiles/AIDS_tb-235.pdf.
2. Forging Partnerships - With Private Health Sector. Available from: URL: http://www.searo.who.int/LinkFiles/Tuberculosis_left32.pdf.
3. 于廣軍, 高解春. 公立醫院改革的國際比較研究, 中國醫院院長, 2007, 9: 39-42.
4. Huntington D, Sulzbach S. Public Policy and Franchising Reproductive Health: Current Evidence and Future Directions, World Health Organization, 2007.
5. Dewan PK, Lal SS, Lonnroth K, et al. Improving tuberculosis control through public-private collaboration in India: literature review. British Medical Journal, 2006, 7541(332), 574-577.
6. 張宏. 巴西初級衛生保健的新嘗試, 中國衛生人才, 2007, 11: 38-39.
7. 高光明. 公立與私立醫療機構的劃分, 國外醫學, 醫院管理分冊, 1998, (3): 115-116.
8. Sheikh K, Porter J, Kielmann K, et al. Public-private partnerships for equity of access to care for tuberculosis and HIV/AIDS: lessons from Pune, India, transactions of transactions of the royal society of tropical medicine and hygiene, 2006, 4(100): 312-320.
9. Arora VK, Sarin R, Lonnroth K. Feasibility and effectiveness of a public-private mix project for improved TB control in Delhi, India. International Journal of Tuberculosis and Lung Disease, 2003, 12(7): 1131-1138.
10. Lonnroth K, Thuong LM, Linh PD, et al. Utilization of private and public health-care providers for tuberculosis symptoms in Ho Chi Minh City, Vietnam. Health Policy and Planning, 2001, 1(16): 47-54.
11. Malmborg R, Mann G, Thomson R, et al. Can public-private collaboration promote tuberculosis case detection among the poor and vulnerable? Bulletin of the World Health Organization, 2006, 9(84):752- 758.
12. Karki DK, Mirzoev TN, Green NT, et al. Costs of a successful public-private partnership for TB control in an urban setting in Nepal, BMC Public Health, 2007, 84.
13. Hurtig AK, Pande SB, Baral SC, et al. Linking private and public sectors in tuberculosis treatment in Kathmandu Valley, Nepal. Health Policy and Planning, 2002, 17(1): 78-89.
14. Newell JN, Pande SB, Bara SC, et al. Control of tuberculosis in an urban setting in Nepal: public–private partnership. Bulletin of the World Health Organization, 2004, 82: 92-98.
15. Schwartz JB, Bhushan I. Improving immunization equity through a public-private partnership in Cambodia. Bulletin of the World Health Organization, 2004, 82(9): 661-667.
16. Banda EN, Simukonda HP, et al. The public/private mix in the health care system in Malawi. Health Policy and Planning, 1994, 9(1): 63-71.
17. Nishtar S, Bile KM, Ahmed A, et al. Process, Rationale, and Interventions of Pakistan’s National Action Plan on Chronic Diseases. Preventing Chronic Disease, 2006, 3: 1.
18. Quy HT, Lan NTN, Lönnroth K, et al. Public-private mix for improved TB control in Ho Chi Minh City, Vietnam: An assessment of its impact on case detection. International Journal of Tuberculosis and Lung Disease, 2003, 7(5): 464-471.
19. Raman AV, Björkman JW. Public-private partnership in the provision of health care services to the poor in India. Global Development Network, 2007, 32.
20. Dewan PK, Lal SS, Lonnroth K, et al. Improving tuberculosis control through public-private collaboration in India: literature review, BMJ, 2006, 332: 574-578.
21. Annigeri VB, Prosser L, Reynolds J, et al. An assessment of pubic-private partnership opportunities in India. Poptech, 2004.
22. Sehgal S, Dewan PK, Chauhan LS, et al. Public-Private Mix TB activities in Meerut, Uttar Pradesh, North India: delivering DOTS via collaboration with private providers and non-governmental organizations. Indian J Tuberc, 2007, 54: 79-83.
23. Kumar MKA, Dewan PK, Nair PKJ, et al. Improved tuberculosis case detection through public-private partnership and laboratory-based surveillance, Kannur District, Kerala, India, 2001-2002. International Journal of Tuberculosis and Lung Disease, 2005, 9(8): 870-876.
24. Rangana S, Ambeb G, Borremans N, et al. The Mumbai experience in building field level partnerships for DOTS implementation. Tuberculosis, 2003, 83: 165-172.
25. Arora VK, Sarin R, Lönnroth K. Feasibility and effectiveness of a public-private mix project for improved TB control in Delhi, India. International Journal of Tuberculosis and Lung Disease, 2003, 7(12): 1131-1138.
26. Murthy KJR, Frieden TR, Yazdani A, et al. Public-private partnership in tuberculosis control: experience in Hyderabad, India. International Journal of Tuberculosis and Lung Diseas, 2001, 5(4): 354-359.
27. Patel A, Ramani KV, Mavalankar DV, et al. Implementing a Public Private Partnership Model for Managing Urban Health in Ahmedabad. Research and Publications, 2007.
28. Ramiah I, Reich MR. Building effective public–private partnerships: Experiences and lessons from the African Comprehensive HIV/AIDS Partnerships (ACHAP). Social Science and Medicine, 2006, 63(2): 397-408.
29. Dreesch N, Nyoni J, Mokopakgosi O, et al. Public-private options for expanding access to human resources for HIV/AIDS in Botswana. BMC Human Resources for Health, 2007, 5: 25.
30. Ramiah I, Reich MR. Public-private partnerships and antiretroviral drugs for HIV/AIDS: lessons from botswana. Health Affairs, 2005, 24: 2.
31. Clark P, O’Brien K. Fighting AIDS in Sub-Saharan Africa: is a public--private partnership a viable paradigm? Med Sci Monit, 2003, 9(9), 28-39.
32. Mantala MJ. Public-private mix DOTS in the Philippines, Tuberculosis, 2003, 83(1-3): 173-176.
33. Sinanovic E, Kumaranayake L. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa. BMC Cost Effectiveness and Resource Allocation, 2006, 4: 11.
34. Ardian M, Meokbun E, Siburian L, et al. A public-private partnership for TB control in Timika, Papua Province, Indonesia. International Journal of Tuberculosis and Lung Disease, 2007, 11(10): 1101-1107.
35. Lönnroth K, Uplekar M, Arora VK, et al. Public-private mix for DOTS implementation: What makes it work? Bulletin of the World Health Organization, 2004, 82: 580-586.
36. Fisher WH, Dorwart RA, Schlesinger M, et al. Contracting between Public Agencies and Private Psychiatric Inpatient Facilities. Medical Care, 1991, 29(8): 766-774.
37. Romana HW. Overview of the Community Care Network Demonstration Program and Its Evaluation. Medical Care Research and Review, 2003, 60, 5S.
38. Morrow H, Collins BK, Smith DR. Public health coalitions: patterns and perceptions in state immunization programs. Jhhsa Fall, 2007: 157-175.
39. Shortell SM, Zukoski AP, Alexander JA, et al. Evaluating Partnerships for Community Health Improvement: Tracking the Footprints. Journal of Health Politics, Policy and Law, 2002, 27: 1.
40. Weiner BJ, Alexander J. A The Challenges of Governing Public-Private Community Health Partnerships. Health Care Management, 1998, 23(2): 39-55.
41. Bazzoli GJ, Stein R, Alexander JA, et al. Public-Private Collaboration in Health and Human Service Delivery: Evidence from Community Partnerships. The Milbank Quarterly, 1997, 75 (4): 533-561.
42. Pirkis J, Livingston J, Herrman H, et al. Improving collaboration between private psychiatrists, the public mental health sector and general practitioners: evaluation of the Partnership Project. Australian and New Zealand Journal of Psychiatry, 2004, 38: 125-134.
43. Browna L, Barnett JR. Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia. Social Science & Medicine, 2004, 58: 427-444.
44. Pirkis J, Herrman H, Schweitzer I, et al. Evaluating complex, collaborative programmes: the Partnership Project as a case study. Australian and New Zealand Journal of Psychiatry, 2001, 35(5): 639-646.
45. Thaldorf C, Liberman A. Integration of Health Care Organizations Using the Power Strategies of Horizontal and Vertical Integration in Public and Private Health Systems. The Health Care Manager, 2007, 26(2): 116-127.
46. Malmborg R, Mann G, Thomson R, et al. Can public-private collaboration promote tuberculosis case detection among the poor and vulnerable? Bulletin of the World Health Organization, 2006, 84(9): 752-758.
47. Patouillard E, Goodman CA, Hanson KG, et al. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature. BMC International Journal for Equity in Health, 2007, 6: 17.
48. Waters H, Hatt L, Peters D. Working with the private sector for child health, Health. Policy and Planning, 2003, 18(2): 127-137.
49. Uplekar M, Pathania V, Raviglione M. Involving Private Practitioners in Tuberculosis Control: Issues, Interventions, and Emerging Policy Framework. WHO, 2001, 285.
50. 周成武, 嚴肅勤, 陳建平, 等. 公私合作伙伴關系在衛生領域的應用, 中國衛生經濟, 2006, 25(5): 73-75.

《中國循證醫學雜志》

公立和私立醫療機構合作提供醫療衛生服務策略的描述性系統評價

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《中國循證醫學雜志》

公立和私立醫療機構合作提供醫療衛生服務策略的描述性系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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