新农合规制政策对乡村医生行为的影响——基于全国性农村医疗卫生社会调查的实证分析  

The Effect of the New Cooperative Medical System on Rural Doctors'Behavior:An Empirical Analysis Based on a National Social Survey on Rural Health Care

作　　者：刘宁 吴少龙[2] 包国宪[1] Liu Ning;Wu Shaolong;Bao Guoxian(School of Management,Lanzhou University,Lanzhou;School of Government,Sun Yat-Sen University,Guangzhou)

机构地区：[1]兰州大学管理学院 [2]中山大学政治与公共事务管理学院

出　　处：《经济社会体制比较》2023年第4期65-76,共12页Comparative Economic & Social Systems

基　　金：甘肃省重点研发计划项目“甘肃省医药大数据系统技术研发与平台设计”(项目编号:20YF8GA068);兰州大学中央高校基本科研业务费专项资金资助“协同治理视角下健康中国建设的绩效评价体系构建与操作方法研究”(项目编号:2022jbkyjd002)。

摘　　要：新农合是我国农村医疗卫生体系建设中的里程碑,而乡村医生则是农村医疗卫生服务供应的中坚力量。文章在“政府规制—医生行为”分析框架下,从政府规制影响个体行为视角评估了新农合对作为基层医疗卫生服务供应者的乡村医生提供公共卫生服务和医疗服务行为的影响。研究发现,新农合对乡村医生行为,尤其是在公立机构执业的乡村医生行为产生了积极调控作用,在引入市场竞争时更是如此。此外,新农合对乡村医生行为的调控作用在既经历过合作医疗又经历过市场化改革的乡村医生群体中更为有效,这一效应也更容易通过诊所所有制的不同与竞争而得到放大。然而,在只经历过市场化改革的乡村医生群体中,新农合的影响相对有限,而且这一群体的乡村医生更容易受到竞争带来的负面影响。A significant development in the Chinese healthcare system is the New Cooperative Medical System(NCMS),which emphasizes the importance of rural doctors in the delivery of services in rural areas.This essay explores the relationship between“government regulations-doctors'behavior”and how NCMS has affected rural doctors'actions.The findings imply that NCMS had a beneficial regulatory impact on rural physicians'behavior,particularly those who had gone through both the reform that created the Cooperative Medical System and the market-driven healthcare system.Notably,clinic ownership and competition can reduce this effect.The influence of NCMS was,however,very limited among those who had merely undergone market-oriented reform,and rural doctors in this group were more vulnerable to the detrimental effects of competition.

关 键 词：医生行为 乡村医生 新农合 政府规制 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学] F323.89[经济管理—保险]