选择性激励下的社区医生签约积极性均衡点研究

摘要

社区医疗契约服务是一种新型医疗改革制度,是未来医改的方向,政府目标是要在2017年实现家庭医生签约服务覆盖率达到30％以上,而实现该目标的关键是如何调动社区医生的签约积极性,因此,社区医生签约积极性均衡点研究具有重要意义.本文创新性地采用集体行动逻辑下的选择性激励理论分析,探讨一个既能调动社区医生签约积极性,又能平衡其与政府及社区居民之间关系的均衡点,并从社区医生的角度获得了调动社区医生签约积极性的均衡点,认为该均衡点既要考虑社区医生的付出成本与收益间的平衡,也要顾及政府及社区居民对社区医生的贡献索取容忍度.%Community medical contract service is a new type of medical reform system,and it is the direction of future medical reform.The govermnent aims to achieve the coverage rate of contract serwice of the family doctors in 2017 reaching over 30％,and the key to achieving this goal is how to arouse the enthusiasm of community doctors in signing contact.Therefore,it is of great significance in studying the equilibriuim point of the enthusiasm of community doctors in signing contact.In this paper,the author adopts the selective incentive theory of the logic of collective action innovatively,discusses a equilibrium point that can not only arouse the enthusiasm of community doctors in signing contract,but also balance the relationship between community doctors and the government and community residents,and obtains the equilibrium point that arouses the enthusiasm of community doctors in signing contract from the perspective of community doctors.The author believes that at this equilibrium point,the balance between the costs and benefits of the community doctors should be taken into account and meanwhile the tolerance of seeking the contributions of community doctors by the government and community resident should be also taken into consideration.