Abstract: Background　Incentives for quality health resources to sink depend on government policies.Policy tools are designed and appropriately selected by the government to drive a series of health sector reforms，so interpreting these tools can best reflect the healthcare reform process.Objective　To explore the characteristics and blind spots of 30 policy documents issued by the central government and the provinces and cities focused on model medical reform，so as to provide a good guide for the effective subsidence of quality health resources.Methods　Using content analysis，from three dimensions of policy classification framework，core competitiveness of medical institutions and policy targets，we selected and interpreted 30 policies incentivizing the allocation of high-quality health resources to primary care issued by the central government，and the provincial and municipal governments of the focus demonstration provinces and cities during the ten years from January 2009 to December 2018 as research objects.With "quality health resources sinking and incentive policy analysis" as the key words，the paper searched through the government portal website，Chinese reform information database and other channels，and analyzed based on the policy classification framework，the core competitiveness of medical institutions and the target of policy action.Results　Among the 150 text units，environmental policy tools were more widely used，accounting for 61.3%（92/150），supply policy tools 24.7%（37/150），and demand policy tools were less used，accounting for only 14.0%（21/150）.Among environmental policy tools，institutional mechanisms are more frequently used than other tools，accounting for 22.8%（21/92） and 21.7%（20/92），respectively.Among the supply-oriented policy tools，the application frequency of training assistance and information platform is relatively high，accounting for 32.4%（12/37） and 27.0%（10/37），respectively.Among the demand policy tools，the traditional medicine service policy tools only account for 14.3%（3/21） of the demand policy tools.In addition，in the dual dimension，the policy items were mostly focused on diagnosis and treatment（60.0%），followed by preventive screening（33.3%），and the least involved rehabilitation and health care stage（6.7%）.Conclusion　We found some core problems existing in the policies，such as the overuse of mandatory environmental policy tools，insufficient effectiveness of supply policy tools in meeting the public health needs，weak interactions between the environmental policy tools，and lack of functionally optimized complementarity between the policy tools.To further incentivize the allocation of high-quality health resources to primary care in China，we put forward the following suggestions：appropriately weakening or reducing the use frequency of mandatory environmental policy tools，increasing the use frequency of supply and demand policy tools，exploration of the optimal combination of policy tools，and appropriately using policy tools according to the specific time and local conditions.

Key words: Health policy, Health resources, Content analysis, Policy analysis

摘要： 背景　激励优质卫生资源下沉有赖于政府的政策驱动。在卫生领域中，政府通过设计和选择适宜的政策工具推动改革，因此，政策工具可被视为解读医改进程的最佳场域。目的　对中央政府和焦点示范医改省市颁布的30份激励优质卫生资源下沉相关政策文件进行文本分析，探寻其中的特点与盲点，从而为优质卫生资源有效下沉提供良好指引。方法　本文采用内容分析法，选取2009年1月—2018年12月我国发布的30份激励优质卫生资源下沉相关政策文件作为研究对象。以“优质卫生资源下沉、激励政策分析”为关键词，通过政府门户网站和中国改革信息库等渠道进行检索，并基于政策分类框架、医疗机构核心竞争力及政策作用靶点3大维度解析。结果　150个文本单元中，环境型政策工具应用较多，占61.3%（92/150），供给型政策工具占比24.7%（37/150），需求型政策工具应用比例较低，仅占14.0%（21/150）。环境型政策工具中，体制机制与法规管制相比其他工具应用更为频繁，分别占22.8%（21/92）与21.7%（20/92）。供给型政策工具中，培训帮扶与信息平台应用频率相对较高，分别占32.4%（12/37）和27.0%（10/37）。需求型政策工具中，传统医药服务政策工具仅占需求型工具的14.3%（3/21）。此外，双维度下，政策条目多集中在诊断治疗（60.0%）方面，其次是预防筛查（33.3%），涉及最少的是康复保健阶段（6.7%）。结论　当前促进优质卫生资源下沉政策仍存在以强制类环境型政策工具为主、供给型政策工具与公众的健康需求契合性不足、环境型政策工具的互动性弱和政策工具间缺乏优化互补等核心问题。建议从适度弱化或降低强制类环境型政策工具的使用频率、增加供给型与需求型政策工具的应用频率、探索政策工具间的优化组合、政策工具应与实际应用时空场景相耦合等方面进一步激励优质卫生资源下沉。

关键词: 卫生政策, 卫生资源, 内容分析法, 政策分析