医生激励机制改革的路径依赖及重建

医生作为公立医院改革的直接体验者和推动者,其积极性的发挥直接影响医改的效果。而要在公立医院改革中实现维护公益性和调动医生积极性的平衡,必须重建医生激励机制。根据制度经济学理论,在改革和重建医生激励机制过程中,必须破解路径依赖,确定重建医生激励机制的路径。在当前背景下,应先对医疗服务价格进行合理定价,然后根据医生的职业性质建立合理的医生补偿机制,同时通过实施支付方式改革等,建立针对医生行为的约束机制,辅以教育和管理培育医生的责任心。

Path Dependence and Reconstruction of the Reform on Doctor Incentive Mechanism

Doctors are direct expefiencers and impellers of the reform in public hospitals, whose initiative directly influences the effect of the reform. The balance between maintenance of public welfare and mobilization of doctor＇s initia- tive in public hospitals lies on the reconstruction of doctor incentive mechanism. According to institutional economic theo- ry, path dependence must be cracked and the path of doctor incentive mechanism be reconstructed in the course of the re- form and the reconstruction of doctor incentive mechanism. In the current context, medical service prices must be reasona- bly set and the reasonable doctor incentive mechanism of doctor＇s professional nature be built. Simultaneously, restriction mechanism for doctor＇s behavior must be established, supplemented with education and management to foster doctor＇s re- sponsibility by means of the reform on payment methods.