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目的:分析契约式社区卫生服务政策执行低效率的原因及对策。方法:创新性地利用法国组织理论,基于组织中的权力与规则,利用理论思想构建了一个适应一般组织的行动者组织分析框架,并在此基础上结合契约卫生服务特点,新构建了契约式社区卫生服务组织分析图,从行动者、权力与规则三者关系分析政策执行效率低问题。结果与结论:应当围绕权力与规则,从合理划分行动者权力;优化组织结构,调整行动者利益关系;发挥规则作用,完善激励约束机制三个方面来提高契约卫生服务政策执行效率。
Objective: To analyze the reason and countermeasure of inefficiency of contractual community health service policy. Methods: Based on French organizational theory, based on the power and rules in the organization, this paper constructs an analytical framework of actors that adapt to the general organization based on the theoretical thought. On the basis of this, combined with the characteristics of the contractual health service, Community health service organization analysis chart, analysis of the issue of low efficiency of policy implementation from the relationship between the three actors, power and rules. RESULTS AND CONCLUSION: We should improve the efficiency of the contract health service policy from three aspects of power and rule, from reasonably dividing the rights of actors, optimizing the organizational structure, adjusting the interests of actors, giving play to the role of rules and improving the incentive and restraint mechanisms.