农村公共卫生服务绩效合同管理模式的分析-analysis of rural public health service performance contract management mode.docx

乡。第二批试点乡由于试点的时间较短结果还不是很稳定。 5.创新与不足 从与合同管理有着密切联系的新公共管理理论、激励理论和博弈论等角度构建了农村公共卫生绩效合同管理模式的理论模型。突破了以往对其分析多停留在政府购买 的层次，多用公共产品提供理论和准公共产品属性论证政府购买的可行性。建立一套适合我国农村实际的绩效合同管理机制。并通过干预试点的方法去检验 和评价这套机制。从绩效合同管理的执行、公共卫生服务提供者管理行为和公共卫生 服务绩效三个方面进行了综合性的评价分析。利用对照组排除社会、经济等的混杂因 素。保证最终结论的科学性和全面性。 本研究所采用的按项目开展流程中发生的费用测算成本法存在着不容易规范或 确定公共卫生服务开展的标准流程，各地区差异造成费用计算存在一定的偏差的缺 点。在建立公共卫生服务评价指标体系方面，由于时间、人力和财力的限制，选取的 样本数量相对较少，在进行效度评价时，未能进行结构效度分析，这也是研究中存在 的一个局限。关键词：绩效合同农村公共卫生服务政府购买Study on the Management Mode of the Performance-based Contract of Public Health Services in Rural AreasABSTRACTTo promote the equalization of basic public health services is one of five priority reform programs of the Health Care System Reform (2009-2011). After the government has clarified its role in public health service management, it attracts most attention to study what kind of management model should be taken to improve the quality, efficiency and equity of core public health services.ObjectiveFor providing the evidence for government’s health reform decision- making, this study aims to explore the concepts and theoretical framework of the management mode of the performance-based contract of public health services in rural areas, to design and implement its operational mechanism, to analyze operation influence factors, to evaluate the implementation results.MethodThe concepts and theoretical framework of performance-based contract management for public health services in rural areas were built through literature analysis, normative analysis and logical reasoning.The literature analysis and expert discussion method were used to construct and verify the operating mechanism, the implementation programs, the cost estimation and the evaluation plan.Based on policy research and the literature analysis, the evaluation indicators of the management mode and the indexes of the public health services performance were initially developed. Delphi method and two rounds of consultation letter were conducted. Excel2003 were applied to da