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本文通过运用外部性理论,梳理比较了政府购买村级医疗卫生服务的三种现行模式,即政府向公办民营村卫生室购买、政府向公助民营村卫生室购买和社会竞买模式。在比较三种模式优劣后,本文认为,目前普遍采用在两种面向村卫生室购买模式在改革初期有一定合理性,但具有过渡性质,市场成熟下的社会竞买模式应是未来发展的方向。最后,在时空设置、供给主体多元化、公私属性区分、资金运作和鼓励创新等方面给出了政策建议。
By using the theory of externality, this paper combs and compares the three current modes of government purchase of village-level medical and health services, that is, the government purchases the public private village clinics and the government purchases the public private village clinics and the social bidding model. After comparing the strengths and weaknesses of the three models, this paper argues that the current prevalence of two modes of purchase for village clinics is reasonable at the initial stage of reform, but the social bidding model with transitional character and mature market should be the direction of future development . Finally, policy recommendations are given in terms of time and space setting, diversification of supply bodies, distinction between public and private properties, operation of funds and encouragement of innovation.