政府便于监管、易于操作:“总额预算+按服务单元付费”组合支付方式预期效果之六

Expected effects of the mixed payment of"Global budget and Service unit"(Ⅵ):government easy regulating and operating

为论证"总额预算+按服务单元付费"组合支付方式是否便于政府监管及操作,基于支付方式设计原理与内涵,使用定性推理的方法,结合2008年上海、山东、江苏4895名医疗卫生服务管理者、组织者和提供者意向调查数据进行论证。结果显示,该组合支付方式下,政府所需设置指标明确、测算方法简单、所需数据易于获得,指标调整也易于操作;一旦实施,实践效果是有明确预期的,效果评价指标是明确的、易于考核的;实践中可能出现的问题及其应对措施也是明确的,只要政府回归监管本职,定能将社会震荡降到最小。组合支付方式改革能够实现温总理提出的"让监管人员易于掌握"的标准。

To answer whether the mixed payment of global budget and service unit is convenient for the government to supervise and operate,the study used qualitative reasoning approach,based on the design principle of the payment,combined with survey data of 4 895 medical and health service managers,organizers and providers in Shanghai,Shandong and Jiangsu in 2008.This article demonstrates that under the mixed payment,the index that the government should set is very clear and the measurement and adjustment method is simple with accessible data;once implemented,the expected effect is very clear and easy to assess;potential problems are easy to treat,as long as the government undertakes its own responsiveness,it will be able to minimize the social turmoil.In a word,the payment reform can meet the standard of Premier Wen＇ s ＂regulators can easily regulate＂.