Quantitative Analysis of China's Rural Doctor Policies from the Perspective of Policy Tools

doi:10.12114/j.issn.1007-9572.2020.00.279

Abstract

Abstract: Background　Rural doctors are the "net bottom" of China's medical and health system. The orderly development of rural doctors cannot be separated from the guidance and support of national policies. Policy tools are used as a link between policy objectives and results. Only by selecting appropriate and effective policy tools and making maximum use of them can the policy results reach the expected value of policy objectives. Objective　To explore the existing problems in the relevant rural doctor policies in China，with a view to providing the reference for the formulation and development of follow-up policies. Methods　The quantitative analysis method was used on June 21 in 2019 to analyze the policy tools in 29 policy documents related to rural doctors issued from 2009 to 2019 at the national level. The policy tools in these documents were analyzed. A two-dimensional analysis framework was constructed from the perspective of policy tool types and rural doctor issues to analyze in depth the policy documents related to rural doctors in China. Results　In the X dimension，capacity building，command，incentive，symbol and exhortation policy instruments accounted for 35.8%（48/134），26.9%（36/134），19.4%（26/134） and 17.9%（24/134） respectively. In Y dimension，growth，treatment，identity and source accounted for 41.3%（52/126），36.5%（46/126），11.9%（15/126） and 10.3%（13/126） respectively. Conclusion　In the X dimension，there was a deviation in the use of policy tools in policy documents related to rural doctors，and the internal structure was unreasonable. In the Y dimension，the attention of policy tools on identity and source issues was still insufficient. It is suggested to balance various policy tools to form a policy synergy，and pay attention to the combination of external coordination and internal systematicness. The treatment issue should be effectively solved to ensure the source of rural doctors. The identity should be changed to improve the quality of rural doctors.

Key words: Rural doctors, Policy tools, Health policy

摘要： 背景　乡村医生是我国医疗保障体系的“网底”，其有序发展离不开国家政策的引导与支持，政策工具作为纽带连接政策目标和结果，选择合适且有效的政策工具并将其最大化利用，才能使政策结果达到政策目标的预期值。目的　探讨我国乡村医生相关政策中存在的问题，以期为后续政策的制定与发展提供参考借鉴。方法　采用政策量化分析方法，于2019-06-21对国家层面2009—2019年出台的29份乡村医生相关的政策文本中的政策工具进行分析，从政策工具类型、乡村医生问题角度构建二维分析框架，深入分析我国乡村医生政策文件。结果　X维度，能力建设型、命令型、激励型、象征和劝诫型政策工具分别占35.8%（48/134）、26.9%（36/134）、19.4%（26/134）、17.9%（24/134）。Y维度，成长、待遇、身份和来源问题分别占41.3%（52/126）、36.5%（46/126）、11.9%（15/126）和10.3%（13/126）。结论　我国乡村医生政策在X维度中政策工具使用存在偏移，内部结构不合理；在Y维度中，身份问题和来源问题政策工具关注度还尚有欠缺。建议均衡各类政策工具，形成政策合力；注重其外部协调性与内部系统性相结合；切实解决乡村医生待遇问题，保障乡村医生来源，转变乡村医生身份，提升乡村医生质量。

关键词: 乡村医生, 政策工具, 卫生政策

LIU Yongwen,DAI Mengna,GUO Jing, et al. Quantitative Analysis of China's Rural Doctor Policies from the Perspective of Policy Tools[J]. Chinese General Practice, 2020, 23(22): 2757-2762. DOI: 10.12114/j.issn.1007-9572.2020.00.279.
刘永文,戴萌娜,郭婧等. 政策工具视角下我国乡村医生政策量化分析[J]. 中国全科医学, 2020, 23(22): 2757-2762. DOI: 10.12114/j.issn.1007-9572.2020.00.279.

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