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[1]戴涛明袁洁马月阳刘军军.基于整体智治视角的江苏省“三医”协同发展与治理路径研究[J].中国卫生质量管理,2026,33(5):28-33.[doi:10.13912/j.cnki.chqm.2026.33.5.06]
　DAI Taoming,YUAN Jie,MA Yueyang.Research on the Pathways for Development and Governance of the "Three-Medicine" Synergy in Jiangsu Province from the Perspective of Holistic Intelligent Governance[J].Chinese Health Quality Management,2026,33(5):28-33.[doi:10.13912/j.cnki.chqm.2026.33.5.06]

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基于整体智治视角的江苏省“三医”协同发展与治理路径研究

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 33 期数: 2026年5期页码: 28-33 栏目: 医疗质量出版日期: 2026-05-15

Title:: Research on the Pathways for Development and Governance of the "Three-Medicine" Synergy in Jiangsu Province from the Perspective of Holistic Intelligent Governance

作者:: 戴涛明袁洁马月阳刘军军; 南通大学第六附属医院

Author(s):: DAI Taoming; YUAN Jie; MA Yueyang; Affiliated Hospital 6 of Nantong University

关键词:: 整体智治; 医疗、医保、医药协同; 医疗改革; 数据治理; 江苏省

Keywords:: Holistic Intelligent Governance; Synergy of Healthcare; Medical Insurance; and Pharmaceuticals; Healthcare Reform; Data Governance; Jiangsu Province

分类号:: R197

DOI:: 10.13912/j.cnki.chqm.2026.33.5.06

文献标志码:: A

摘要:: 目的系统分析江苏省医疗、医保、医药（“三医”）协同发展与治理路径，评估协同改革的综合效应。方法基于整体智治理论，梳理江苏省在政策协同、医保支付方式改革、医疗服务体系建设、药品供应保障与信息协同等方面的实践进展，并构建“三医”协同治理系统动力学模型，通过多情景仿真分析不同政策组合的治理绩效。结果江苏省通过跨部门协作机制、DRG/DIP支付改革、药品集中采购和统一信息平台建设，初步形成“三医”协同治理框架。仿真结果显示，单项改革可改善基金运行状况和减轻患者负担，但综合推进支付改革、集采扩面与信息协同的效果更为显著，可明显提升医保基金结余，降低患者自付比例，并提高医疗服务覆盖率。结论整体智治为“三医”协同治理提供了系统化实现路径，多政策协同联动是提升治理效能的关键。

Abstract:: ObjectiveTo systematically analyze the development and governance pathways of healthcare, medical insurance, and pharmaceuticals (the "three-medicine") synergy in Jiangsu Province, and to evaluate the comprehensive effects of coordinated reforms.MethodsBased on the theory of holistic intelligent governance, this study reviewed the practical progress of Jiangsu Province in policy coordination, reform of medical insurance payment methods, healthcare service system construction, pharmaceutical supply security, and information coordination. A system dynamics model for the coordinated governance of the "three-medicine" sectors was constructed, and multi-scenario simulations were conducted to analyze the governance performance of different policy combinations.ResultsThrough cross-departmental collaboration mechanisms, DRG/DIP payment reforms, centralized pharmaceutical procurement, and the establishment of a unified information platform, Jiangsu Province has initially formed a framework for coordinated governance of the "three-medicine" sectors. Simulation results indicated that individual reforms could improve fund operation and alleviate patient burdens. However, the comprehensive advancement of payment reforms, expanded centralized procurement, and information coordination yielded more significant effects, notably increasing medical insurance fund surpluses, reducing patients’ out-of-pocket expenses, and improving healthcare service coverage.Conclusion Holistic intelligent governance provides a systematic approach to achieving coordinated governance of the "three-medicine" sectors, and multi-policy synergy is key to enhancing governance effectiveness.

参考文献/References:

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更新日期/Last Update: 2026-05-15