医保支付方式与公立医院薪酬制度改革协同机制研究——基于期望理论的领薪医生行为分析  

Coordination mechanism of medical insurance payment system and salary system reform in public hospitals:An expectancy theory analysis on paid physician behavior

作　　者：孙杨[1] 顾雪非[1,2] 冯友梅 SUN Yang;GU Xue-fei;FENG You-mei(School of Political Science and Public Administration, Wuhan University, Wuhan Hubei 430072, China;China National Health Development Research Center, National Health Commission, Beijing 100191, China;School of Health Science, Wuhan University, Wuhan Hubei 430072, China)

机构地区：[1]武汉大学政治与公共管理学院,湖北武汉430072 [2]国家卫生健康委卫生发展研究中心,北京100191 [3]武汉大学健康学院,湖北武汉430072

出　　处：《中国卫生政策研究》2018年第12期45-50,共6页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(71573192;71303012);人社部项目(2016-203-03139)

摘　　要：医改进入深水区,改革的整体性、系统性和协同性尤为重要。通过期望理论分析发现,医生行为受到三对激励关系的连续影响,中断或扭曲的激励关系均不利于引导合理的医生诊疗服务提供行为。在这三对激励关系中医保支付方式和医生薪酬制度两项改革占据重要地位,且关联度极高,只有两者有效协同,才能实现对医疗机构和医生的"激励相容",以达到预期改革的目标,实现医生行为转变。The in-depth improvement of medical treatment is particularly important for the integrity, systematicity and synergy of the reform. Through the theoretical analysis of physician s incentive expectation, it was found that the doctor s behavior is continuously affected by the three pairs of motivational relationships, and the interrupted or distorted incentive relationship is not conducive to guiding the reasonable service delivery from physicians. In these three pairs of incentive relationship, the two reforms of medical insurance payment system and physician s salary system occupy an important position, and their degree of correlation is extremely high.Only when the two are effectively synergistic can the “incentive compatibility” of public medical institutions and physicians be realized to achieve the expected results. The goal of is to make a change in the physician s behavior as expected by the health system in the reform.

关 键 词：支付方式 薪酬制度 公立医院 期望理论 激励相容 

分 类 号：R197[医药卫生—卫生事业管理]