以科学态度在卫生系统发展中构建与评价激励约束机制——兼评宁夏盐池与海原两县支付制度改革与研究

Establishing and evaluating incentive and restraint mechanisms in the development of healthcare systems with scientific attitude

本文结合宁夏回族自治区盐池与海原两县支付制度改革与研究实践,阐述了如下观点:构建合理的激励约束机制是卫生系统可持续发展的支撑;合理激励约束机制的设计应以卫生系统目标改进为导向,兼顾各方和短长期利益;机制切换重在实施过程中利益相关方的配合协调与改革主导部门的实施推进;没有严谨科学的研究为依据的机制创建与评价难以令人信服。

Based upon the reforms and research practices of the provider payment system used in Yanchi and Haiyuan county of the Ningxia Hui Autonomous Region,this paper illustrates the following points：the establishment of appropriate incentive and restraint mechanisms is the core support to healthcare system development; the design of appropriate incentive and restraint mechanisms should be oriented according to improvements in healthcare system goals,taking into account the interests of all stakeholders and balancing them between the short-term and long-term; incentive transfers should be focused on the coordination of stakeholders with the departments responsible for mechanism implementation and promotion; incentive development and evaluations in absence of rigorous scientific research are unconvincing.