机制设计理论下农村公共卫生服务私立卫生机构供给模式构建

Constructing supply mode for public health services in rural areas by private health institutions on perspective of mechanism design theory

目的运用机制设计理论设计农村公共卫生服务私立卫生机构供给模型及实现的社会支持系统方案。方法对调查县的公共卫生服务供给现状进行调查,并分别针对不同的参与主体进行问卷和针对性访谈。结果 私立医疗机构群众认可度低,群众就医选择倾向于公立医疗机构;专家学者对于私立卫生机构提供公共卫生服务持怀疑态度;私立卫生机构提供公共卫生服务具有可行性。结论 整体资源配置政府干预,保证公平性;修订医疗卫生机构管理模式,限制公立医疗机构的规模;调整医疗机构分类标准,进行二次分类;调整税收政策,分级分等;严格公平准入;进行服务评级,据此修订诊疗授权权限和税收标准;完善法律体系。

Objective Using mechanism design theory to construct the supply mode of private health institutions for public health services in rural areas and achieve the solutions of social support system. Methods Investigating the supply situation of the sampled county＇s public health service,and applying questionnaires and targeted interviews to diffierent participating subjects. Results The distribution of the public health resources in rural areas was uneven,mainly supplied by government.The rate of private medical institutions appoved by the masses was low,people tended to consult public medical institutions for medical treatment.Experts and scholars were skeptical for the service provided by the private health institutions.However,it is considered that providing public health services by private health institutions is feasible. Conclusions The mode of medical institutional management needs to be revised;the size of the non-profit medical institutions needs to be limited;the classification and tax policy of medical institutions needs to be adjusted;fair access must be strict;service grading should be extablished;delegated authority and tax treatment standard should be accordingly revised;Fairness of the governmental intintervention in the overall allocation of resources should be ensured;The legal system should be continuously improved.