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我国正在推行把村医集中到村卫生室执业即“一村一室”政策;未集中执业的村医为“非法行医”。调研发现,该政策改善了村卫生室条件,但也存在两大问题:一是条件更差的“非法诊所”为何依然有竞争力;二是收入分配平均主义,对高水平村医激励不足。建立农民就医行为选择模型分析“非法诊所”存在的原因发现,在乡土社会的农村,因为熟悉和直接间接联系,“非法诊所”可获得村民信任,并在方便度、费用等方面具有优势,其有存在价值。建立村医执业行为选择模型分析收入平均分配的影响发现,在“非法诊所”存在前提下,高水平村医将退出村卫生室而选择单独执业,低水平村医将集中执业,导致村医水平的逆向选择,并导致“一村一室”政策难以持续。
Our country is implementing the policy of focusing village doctors to practice in village clinics, namely “one village one room” policy; village doctors who are not practicing centrally are “illegally practicing medicine”. The survey found that the policy improved the condition of village clinics, but there were also two major problems: First, the conditions are worse, “illegal clinics,” why they are still competitive; second, income distribution is equalitarianism, high levels of village medical incentives insufficient. The establishment of peasants to choose the model of medical treatment “illegal clinics, ” the reasons for the existence found in the rural areas of rural areas, because of familiar and direct indirect contact, “illegal clinic ” to obtain the trust of villagers, and convenience, costs, etc. Has the advantage of its existence value. Establishing a Choice Model of Village Practitioners’ Practice Choosing an Analysis of the Effect of Average Income Distribution It is found that under the premise of “illegal clinic ”, high-level village doctors will leave the village clinics and choose to practice alone, and low-level village doctors will practice intensively, Medical level of adverse selection and lead to “one village one room ” policy unsustainable.