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健康服务贸易。

Trade in health services.

作者信息

Chanda Rupa

机构信息

Indian Institute of Management, Bangalore, India.

出版信息

Bull World Health Organ. 2002;80(2):158-63.

Abstract

In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.

摘要

鉴于卫生部门全球化程度日益提高,本文利用《服务贸易总协定》中界定的贸易模式特征,研究了卫生服务的贸易方式。贸易模式包括通过实体和电子手段跨境提供卫生服务,以及消费者、专业人员和资本的跨境流动。对卫生服务贸易在公平性、效率、质量和医疗保健可及性方面的正负影响进行考察后发现,卫生服务贸易带来的利弊参半,政策措施在减轻不利后果和促进收益方面可发挥明确作用。文中概述了一些政策措施和优先行动领域,包括应对“人才外流”的措施;增加对卫生部门的投资并优化投资重点;促进私营和公共卫生保健服务之间的联系以确保公平。卫生服务贸易的数据收集、衡量方法和研究都需要改进,以便更好地评估这种贸易的规模和潜在影响。在此背景下,卫生服务贸易的潜在成本和收益受卫生部门的基本结构条件以及现有监管、政策和基础设施的影响。因此,需要采取适当政策和保障措施,以利用卫生服务全球化带来的机遇。

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