我国社区卫生服务机构基本药物零差率政策的完善策略——基于合作博弈理论的分析

为缓解"看病难、看病贵"问题,在社区卫生服务机构开始实施基本药物零差率政策。在合作博弈视角下,将零差率政策实施过程中的政府、医药企业、社区卫生服务机构、社区居民视为一个非完全共同利益整体进行分析。研究发现该整体内部各主体之间对实现基本药物零差率存在愿景和使命、路线、目标、实现过程、规章制度等冲突,为了更有效地推进零差率政策的实施,提出运用理性机制、效用转移机制、协商机制来减少各主体之间的冲突,实现整体利益的最大化。

Research on the improvement of zero profit policy of essential medicines at community

In order to solve the problem of difficulties and expense in seeing a doctor, the government implemented the zero-profit policy of essential medicines. From the perspective of the cooperative game theory, the zeroprofit drug supply is a non unifited stakeholder system, its elements involved with the government agencies, community health service agencies, community residents and pharmaceutical company and circulation enterprises. There are many conflicts between the elements. Based on analysis we know that there exist conflicts between the elements resulted in conflict, such as mission and vision, objectives and implementation process, and also the understanding of relevant regulations and procedures. The government needs to use different rational mechanisms, utility transfer mechanism and effective consultation mechanisms to make the system run smooth.