农村医疗机构诊治技术优化和补偿机制改革试点研究的理论与设计

The Theory and Design of Research on Health Technology Optimization and Compensation Mechanism in Rural Health Facility

为规范医疗行为、改进医疗质量、控制不合理医疗费用、探索农村医疗机构与宏观管理政策双向联动机制,依据PRECEDE-ROCEED模型和机制设计理论提供的分析框架,设计以临床路径管理、政府部门联动的补偿机制改革和信息化监管三方同步推进的干预模式,在卫XI项目地区开展综合干预试点研究,并采用逐步推进式方式,有计划逐步地将综合干预措施推广到卫XI项目和非项目地区,为公立医院改革的突破路径积累经验和借鉴。

To behave medical practices,improve qualities of care,control unreasonable medical costs,explore the mechanism of two-way interaction between rural hospitals and macro policies of management,under the analytical framework of PRECEDE-PROCEED model and Theory of Mechanism Design,planning the simultaneously put forward of three interventions including clinical pathway management,the reform of compensation mechanism conducted by multiple sectors of governments and information-based supervision,the intervention study was done in the areas of health XI project.The stepped wedge trial design was used to scale up interventions gradually,and also provide reforms of public hospitals with experiences.