基于激励相容的医防融合困境与策略分析  

Analysis on the dilemma and strategy of healthcare and prevention integration based on incentive compatibility

作　　者：滕黎 戴悦[2] 李跃平[3] Teng Li;Dai Yue;Li Yueping(School of Public Health,Fujian Medical University,Fuzhou 350122,China;Health Research Institution,Fujian Medical University,Fuzhou 350122,China;School of Arts and Sciences,Fujian Medical University,Fuzhou 350122,China)

机构地区：[1]福建医科大学公共卫生学院,福州350122 [2]福建医科大学卫生健康研究院,福州350122 [3]福建医科大学文理艺术学院,福州350122

出　　处：《中华医院管理杂志》2022年第8期570-574,共5页Chinese Journal of Hospital Administration

基　　金：福建省科技厅创新战略项目(2021R0054)。

摘　　要：医防融合是实现"大卫生、大健康"格局的重要路径,然而,目前我国医防融合工作难以落到实处,重要原因在于缺乏有效的激励相容策略。本研究基于激励相容理论提出了医防融合多级委托代理链条,以委托代理链条中各利益主体之间的激励传导为分析框架,探讨了医防融合激励不相容的困境,并结合三明市医防融合实践,从政府、医疗机构、医务人员、公共卫生人员和居民层面分别提出了统筹医保基金和公共卫生资金使用、加强组织管理和考核激励、奖励健康促进管理工分、成立健康科普团等医防融合策略。Integration of healthcare and prevention is key path to achieving the pattern of"macro healthcare,macro health".However,it is hard at present to fully integrate healthcare and prevention in China,mostly due to the lack of effective incentive compatibility strategies.Based on the incentive compatibility theory,this study proposed a multi-level principal-agent chain of healthcare and prevention integration.Taking the incentive transmission among stakeholders in the principal-agent chain as the analysis framework,the dilemma and causes of incentive incompatibility of healthcare and prevention integration were studied.Combined with the proctice of healthcare and prevention integration in Sanming city,the incentive compatibility strategies of healthcare and prevention integration were proposed at the level of government,medical institutions,medical staff,public health staff and residents.These strategies refer to coordinating the use of medical insurance funds and public health funds,strengthening organization management as well as assessment and incentive,rewarding health promotion management points,and setting up health science popularization teams.

关 键 词：公共卫生 医防融合 激励相容 委托代理 

分 类 号：R197.1[医药卫生—卫生事业管理]