Exploring the System Roots of Service Capacity Weakening in Chinese Primary Medical Institutions / 中国卫生经济

The difficulty and expense of seeing a doctor was attributed to the out-of-level diagnosis and treatment, and the out-of-level treatment was due to the weakening of the basic medical service capacity. Since the new medical reform,the state has invested a lot, which led to the weakening of the primary medical service capacity. Exploring the institutional root of the weakening of grass-roots medical service ability could help to find the realistic path to enhance the service capacity of grass-roots medical institutions. Enhancing the service capacity of primary medical institutions was the only way to implement graded medical treatment. The administration of medical institutions restricted the improvement of service capacity of primary medical institutions, and the root of administration was the existing medical and health system. Only by starting from the reform of the system and realizing the administration of primary medical institutions, the service capacity of primary medical institutions could be enhanced.

"On the policy construction of""Cancelling Budgeted Posts"" in the public hospital:Origination, experience and expectation" / 中国卫生政策研究

The institutional origin of Chinese public hospitals' management system of the budgeted post is the former Soviet Union's national economic budget management system, and the realistic origin is the realistic require-ments since 1949 . The reform experiece of both above suggests that the reform policy about cancelling budgeted posts in the public hospitals was not the result of the different pay, the same work dependeds on whether the budgeted post or not, but rooted in defects in management system of the budgeted post, which include the fracture of the ownership and the responsibility subject, the bottleneck of hospital decision-making ability, the obstacles of the talent flowing and separation of the payment system. This policy is only reform strategy of de-administration, rather than promoting the comprehensive marketization of public hospital. so the policy aboutcancelling budgeted posts is the beginning of comprehensive reforms about hospital corporate governance, medical security system, and medical service compensation. The specific methods of the medical service compensation will become the focus of the further reform. According to the foreign reform experiences and our reform practices, Policymakers would get health insur-ance and government purchase as the main compensation methods in future. However, because of the imbalance of e-conomic development, the diffcult of systematic reform, inertia obstacles of the old management system of the budge-ted post, we should make the comprehensive plans and cautiously advance the measures.