政策工具视角下乡村医生相关政策文本分析

Text Analysis of Rural Doctors'Relative Policies from the Perspective of Policy Tools

目的:对新医改以来我国中央政府层面颁布的38篇乡村医生相关政策进行量化分析,探讨政策工具使用,过程中存在的问题,为进一步调整和优化乡村医生政策提供有益参考。方法:基于Rothwell&Zegveld的政策工具分类方,法,对乡村医生政策文本进行分类与编码,从基本政策工具和新医改不同时期两个维度对其进行分析。结果:在136个政,策编码中,环境型、供给型和需求型政策工具分别占49.27%(67/136)、33.82%,(46/136)、16.92%(23/136)。在环境型,政策工具中,目标规划(21.32%)与法规管制(13.24%)使用较多,标准设计(9.56%)和监督考核(5.15%)使用相对较,少;在供给型政策工具中,人才培养(19.85%)使用最多;需求型政策工具中政府购买(2.94%)、价格补贴(6.62%)、医保,支付(4.41%)和示范项目(2.94%)使用均较少。在新医改的第一、二阶段,乡村医生政策工具的使用以环境型(54.76%;51.28%)为主,第三阶段以供给型(50%)为主。结论:乡村医生政策工具的使用以环境型为主,需求型工具较少,,要进一步优化各类政策工具的内部结构;政府仍然要重视乡村医生政策的制定,调整各类政策工具的使用,促进政策的发,展与落实。

Objective To explore the problems existing in the use of policy tools related to rural doctors,and provide useful references for adjustment and optimization of rural doctor policies.Methods Text of policies related to rural doctors was classified and encoded by Roth well&Zegveld policy tool classification method,and analyzed from dimensions of basic policy tools and different periods of China Health Reform.Results Among the 136 policy codes,environmental,supply-side and demand-side policy tools accounted for 49.21%(67/136),33.82%(46/136)and 16.92%(23/136),respectively.Among the environmental policy tools,target planning and regulatory control were more used,while standard design,supervision and assessment were less used.Among the supply-side policy tools,talent cultivation was widely used.Demand-side tools such as government purchase,price subsidies,medicare payments,and demonstration projects were rarely used.In the first and second stage of the new medical reform,the use of policy tools was mainly in environmental tools,and was mainly in supply-side tools in the third stage.Conclusion The application of rural doctors'policy tools is mainly based on the environment tools,while the demand-side tools are insufficient.It is necessary to further optimize the internal structure of various policy tools.The government should still attach importance to formulate the policy of rural doctors,adjust the use of policy tools,and promote the development and implementation of the policy.