宁波市江北区社区卫生服务综合配套改革的模式及经验

公益性机制的建立是现阶段社区卫生服务改革研究的热点问题。本文从公共政策理论和实践两个维度对宁波市江北区以"公益性"为主导的综合改革模式进行了剖析和介绍。宁波江北区进行了社区卫生服务收支两条线的形态机制、内部激励补偿机制和绩效考核机制三位一体的公益性制度探索。从改革中发现,以经济效益为导向的运行体制是社区卫生服务公益性核心价值缺失的根源。因此建立收支两条线制度,切断社区卫生服务趋利行为是公益性改革的抓手,而合理的利益补偿机制和以公益性为导向的绩效考核制度则是社区卫生服务公益性回归的制度保证。

The mode and experiences of the comprehensive reform of community health services in Jiangbei District Ningbo City

To build a public welfare system is a hot issue in current researches of community health service reforms. This article has analyzed and introduced the comprehensive reform which ＂public welfare＂ is in the dominant position in Jiangbei District Ningbo City both from theoretical and practical dimensions. Jiangbei District has explored economic reconstruction operation mechanism, internal motivate mechanism and performance evaluation mecha- nism of community health services. The research found that the economic benefits-oriented system is the cause of missing public welfare in community health services. Therefore, the establishment of separation of revenue and ex- penditure system, to cut off benefit behavior is an effective action in community health services public welfare reform ; a reasonable compensation mechanism and a public welfare-oriented performance appraisal institution are the system guarantees that will lead public welfare to return into the community health service.