Research Of The Community Health Services Delivery Based On Principal-Agent Relationship

The role of local governments in the production and provision of public services is defined clearly. The independent relations between production and provision mean that the government would have multiple arrangements to deliver the public services. As to the community health service delivery system, the government could seek some market players and social organizations to deliver service directly. The public community health institute as a direct service producer also had a principle-agent combination with the government in the previous community health service delivery, while there were always serious inconsistencies between the expectation of the client and the behavior of the agent because of the lack of the formal contractual restrains, which are the source of low-efficiency of public medical institute. There are many solutions; however trusteeship is one of the important ways to resolve the problems. The local government as a client establishes a formal contractual relationship with the agent by signing contracts in the trusteeship attempt. Restrained by the contract, the client promotes the behavior of the agents to satisfy expectation of the clients through the contractual design of community health service provision in the core of the choice of agent, the structural design of contract, the implementation evaluation of contract and contractual supervision. And it is the key element to introduce the incentive mechanism. As a kind of market-oriented operation on public services, trusteeship draws lessons from the ideas of the New Public Management Movement. In the trusteeship of community health services, the government plays the role of propellant and supervisor. Furthermore, the market-oriented agents as the producers are able to provide better services and productions in lower cost by the utilization of competition and scientific management methods.