Study On Public Health Services Supply In Rural Areas By Private Health Institutions In Perspective Of Mechanism Design Theory

Objective:This article researched at the basis of the public health services in our country, especially in rural public health service supply situation and existing problems, a comprehensive understanding of the basis of efficiency, drawing on systematic theory and practical experience of more mature domestic and international public health services on private participation in the supply for studying, and submit research ideas of the supply of private health institutions for public health service in rural areas, combined with a typical case investigation and analysis of this research, to make out the supply model of private health institutions for public health services in rural areas in perspective of mechanism design theory and how to achieve social support system solutions, including public health coordination between stakeholders in the content (such as functional division of labor, profit distribution, management constraints, etc.); policy support (compensation, security, etc.), so as to explore the implementation path.Methods:1.LiteratureRetrieval systemly and making data query for current situation of rural public health services, problems, status of private health facilities in our country, data reports and related researches results. On this basis, the classification results of the study was compared and summarized the main ideas.2. Scene typical surveyInvestigated the supply situation of sampled county's public health service, and taken questionnaires and targeted interviews to the different participation subject.3. Semi-structured in-depth interviewAccording to predetermined access issues, and data stratified, taken in-depth interviews with the health administrative departments at all levels, public health systems staff, academics respectively in selected area, to adequately collect views and opinions of experts of relevant interest groups to the supply rural public health services, from which to explore factors of diversity supply of rural public health service system established, and discharged in accordance with the order of importance.4. Statistical AnalysisUse appropriate statistical methods, to screening and analysis the key factors and indicators for influence rural public health service supply capacity, supply efficiency, the feasibility of body other than government to participate the supply of rural public health service, etc.5. Mechanism Design Theory Mechanism DesignFirstly, analyzed the current supply of rural public health services and relevant policy background, raised on this basis, take the goal of public health services, and in accordance with the principle incentive compatibility specificially designed mechanism of private sector participation in health rural public health service, in balanceof delivery self-behavioral strategies in the personal and social goals.Results:1. The distribution of the public health resources in rural areas is uneven, mainly supplied by governmentThe public health resources are unevenly distributed, there are more resources in the easten region, the situation in central and western regions have almost the same resources, central slightly better than the west. In the same area, distribution of resources between different cities is not balanced; the total of health input by government are great, but is inadequate per capita; in public health provision is mainly provided by the government, the other forces involved in near-zero; level of staff who provide public health services is lower overall, and the city was better than that in rural areas; with the medical model and changes in disease spectrum, rural public health services are facing new challenges.2. The rate of private medical institutions appoved by the masses is low, people tend to public medical institutions for medical treatment options.92% of the persons under investigation take public sector health institutions as the first choice for medical treatment, because of short distance, the reasonable cost; 1.7% preferred private medical institutions. The reason of do not choose the private health institutions is do not believe them and more like government-run hospitals; the one who choose private health sector, mainly treat for the common cold and other more common diseases; private and public health institutions was no significant difference in terms of the cure rate etc.3. Experts and scholars are skeptical for the private health institutions provide public health services. Experts'advice for public health services focused primarily on that government should lead it; social forces can not participate in public health services, the reasons are mainly about the purpose of profit-oriented business, equipment and technical limitations, etc. Government policy support for private health institutions is lack managing during setting up phenomenon is still serious; some government agencies take the way of banning private institutions when basic medical health system established, private institutions are forced to become "public", which did not change the actual nature.4. Private health institutions providing public health services is feasible.Private health institutions entirely feasible to provide public health services, they get external and internal conditions. New healthcare reform plan also clearly related to the content; private health institutions have relatively substantial quantity of a certain economic strength, rich human resources, can make up for inadequate status of supply of public health services in rural areas in certain extent.5. Briefly described on mechanism design theory, and demonstrate feasibility of the method.Economic mechanisms theory is under any given economic or social goals, in conditions of decentralized decision-making about free choice and voluntary exchange, whether and how to design an economic mechanism (that is, what kind of formulation of laws, rules, policies, regulations, resources configuration rules) makes the goals of personal interests between economic actors and designers agree on. Public health services targeted clearly, freedom of choice and decision-making under the conditions of free exchange, in line with conditions of mechanism design theory.Suggestions: 1.The policy level.Revised the mode of medical institutions management, limit the size of non-profit medical institutions; adjustment classification of medical institutions; adjusting the tax policy; strict fair access; makeing service ratings, licensing authority and accordingly revised the tax treatment standards; government interventing in the allocation of resources to ensure fairness; improve the legal system.2. Operational levelTo establish uniform standards of public health services by making city as a unit, to approve health funding gap and avoid the resulting moral hazard; transfer payments as the basis of standards of public health expenditure per capita, grants to implement formulaic; to establish a strong multi-band excitation fusion mechanism; finally, take government health balance as one aspect of the government assessment, and establish mechanism of government accountability and incentives.