Government Subsidy Mechanism On Urban Community Health Instituations In Empirical Evidence From X District Shanghai

As the most accessible,most convenient and most interactive health service institution,grassroots medical and health institutions carry the functions of providing basic public health services and basic medical services for residents in the jurisdiction.They are an important part of China's medical and health system.The effective operation of medical and health institutions will directly affect the realization of the goal of building a ?graded diagnosis and treatment‘ system in China.At the same time,based on the current situation of foreign medical reform and the actual operation of China's medical and health system,domestic and foreign research literatures suggest that the financial investment mechanism and related policy research to ensure the operation of primary health care institutions is a common hotspot and focus of research at home and abroad.One of the main reasons for limiting the current public welfare development of primary health care institutions is the lack of financial input.However,compared with the operational characteristics and financial input mechanism of grassroots medical and health institutions in foreign developed countries,the public welfare of grassroots medical and health service institutions in China is insufficient.The theoretical basis and practice basis of financial input are biased,and patients' self-paying fees are rising.The phenomenon of ?difficult to see a doctor and expensive to see a doctor‘ is urgently needed to be resolved.Based on this,this paper uses the combination of literature and existing data research,qualitative research and quantitative research to sort out and generalize the common characteristics and common rules of public welfare operation of foreign-level developed medical institutions in foreign countries,and then to China's cities.The objectives and contents of the public welfare operation of grassroots medical and health institutions are defined: established by the state,government financial input and urban basic medical insurance as financial support,supplemented by market operation mechanism,for the purpose of protecting public health,free or very low The method of collecting fees provides basic medical and health services to residents in the jurisdiction.At the same time,in order to explain the rising self-cost of patients in China and analyze the necessary conditions for ensuring the operation of public welfare,this paper takes Shanghai X District as an example to address the current state of financial investment,operational mechanism and free medical care of grassroots health service institutions in the district.The feasibility and standardization workload have been thoroughly studied and analyzed.It is found that the financial investment by the district government alone cannot achieve the free service of primary medical care;the urban basic medical insurance fund has a certain feasibility for the funding gap of free medical care;Freedom is not enough to achieve the public welfare operation of health institutions.The organization has a ?profit-seeking‘ work motivation,and the implementation of standardized workload has not circumvented this problem.Based on the above findings,this paper draws on the operational characteristics and general rules of the primary medical and health institutions in developed countries,and proposes targeted policy recommendations for the problems existing in the health services of the X districts in Shanghai and the public welfare operation of the urban community health service institutions nationwide.