山东省基本药物筹资政策对乡镇卫生院行为的影响研究

左根永; 孙强; 李凯; 杨慧云

引用本文：左根永,孙强,李凯,等.山东省基本药物筹资政策对乡镇卫生院行为的影响研究[J].中国卫生政策研究,2011,4(11):13-18

山东省基本药物筹资政策对乡镇卫生院行为的影响研究

投稿时间：2011-09-07 修订日期：2011-10-14 PDF全文浏览 HTML全文浏览

山东大学卫生管理与政策研究中心

摘要:目的：为完善基本药物筹资政策提供信息和依据。方法：通过综述和理论研究建立研究模型、提出研究假设，以3县9个卫生院获取的定量和定性证据来验证相关假设。结果：基本药物筹资政策、其他基本药物制度和非正式规则联合作用会改变乡镇卫生院的筹资和激励结构，最终影响乡镇卫生院的筹资行为和应对策略；同时，非正式规则的地方性差异会导致基本药物筹资行为的多样性。建议：加大政府补助，形成良性的筹资和激励机制；以乡镇卫生院的功能为基础采取措施适当增加药品品种；适当扩大新农合基金的报销范围；建立监测与督导机制，提高乡镇卫生院采用非正式规则的预期成本。

关键词:基本药物筹资政策乡镇卫生院行为

基金项目:山东大学自主创新基金（自然科学类）（2010TS105），教育部哲学社会科学研究重大课题“深化医药卫生体制改革研究”（09JZD0031）

Research on the behaviors of township health centers stimulated by financing policy of essential medicines in Shandong province

Abstract:Objective: To provide information and evidence for financing policy of essential medicines. Methods: This article reviewed relevant policy documents, constructed the theoretical framework and presented the study hypothesis that was confirmed by the quantitative and qualitative evidence from nine township health centers in three counties. Results: The financing policy, together with other institutional and informal rules of essential medicines changed the financing and incentive structures of township health centers, and ultimately affected their financing behavior and coping strategies. At the same time, local differences of informal rules lead to diversity of financing behaviors for the essential medicines. Recommendations: To improve government compensation in order to form benign financing and incentive mechanisms; to increase the list of essential medicines according to township health centers’ functions; to increase benefit package of new rural cooperative medical scheme to cover more essential medicine; and to construct monitoring and supervision mechanisms in order to increase the expected cost for township health centers to apply informal rules.

Key words:Essential medicines Financing policy Township health center Behavior

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