在健康保险国家建立促进健康的社会服务:比较德国、瑞士和奥地利

IF 1.5 Q3 PUBLIC ADMINISTRATION
Caspar Lückenbach, Verena Biehl, T. Gerlinger
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引用次数: 0

摘要

预防和促进健康是福利国家活动的重要领域,可被视为关键基础设施的组成部分。近年来,在西方福利国家,这一比例已大幅扩大。在德国、瑞士和奥地利的医疗保险国家,出现了新的组织形式。本文描述了这三个国家预防和健康促进组织的演变和现状,并探讨了所选择的机构形式的合法化模式。为此目的,对卫生改革、辩论和主要利益攸关方的发言进行了分析。在“规范性”合法化模式和“功能性”模式之间进行了区分,后者表明了一种“社会投资”战略。在德国,2015年的《预防法》(Prevention Act)创造了一种制度结构,在这种结构中,相关行为体密切合作。它还使健康保险基金发挥突出作用。在瑞士,各州负责预防和促进健康;在联邦一级,主要机构是联邦公共卫生局(BAG)和瑞士健康促进基金会(Gesundheitsförderung Schweiz)。在奥地利,Länder主要负责,但联邦一级通过建立Gesundes Österreich GmbH和加强协调而变得重要。虽然在所分析的辩论和文件中没有遇到“社会投资”一词,但通常与之相关的许多论点越来越多地用于预防和促进健康。相比之下,规范性的理由似乎正在失去重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Establishing social services for health promotion in health insurance states: Germany, Switzerland and Austria compared
Prevention and health promotion are important areas of welfare state activity and can be considered parts of the critical infrastructure. They have been considerably expanded in Western welfare states in recent years. In the health insurance states of Germany, Switzerland and Austria, new forms of organisation have emerged. The article describes the evolution and status quo of the organisation of prevention and health promotion in the three countries and explores the legitimisation patterns for the chosen institutional forms. To this end, health reforms, debates and statements of key stakeholders are analysed. A distinction is made between ‘normative’ legitimisation patterns and ‘functional’ ones that indicate a ‘social investment’ strategy. In Germany, the 2015 Prevention Act created an institutional structure in which the actors involved cooperate closely. It also gives the health insurance funds a prominent role. In Switzerland, the cantons are responsible for prevention and health promotion; at federal level the main bodies are the Federal Office of Public Health (BAG) and the Swiss Foundation for Health Promotion (Gesundheitsförderung Schweiz). In Austria, the Länder are largely responsible, but the federal level gained importance by establishing Gesundes Österreich GmbH and strengthening coordination. While the term ‘social investment’ is not encountered in the debates and documents analysed, many arguments commonly associated with it are increasingly used in the context of prevention and health promotion. In contrast, normative justifications seem to be losing importance.
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来源期刊
European Journal of Social Security
European Journal of Social Security PUBLIC ADMINISTRATION-
CiteScore
1.80
自引率
14.30%
发文量
28
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