通讯作者: 蒋艳, jy_ftn@163.com

DOI：10.12201/bmr.202606.00022

Analysis of the Policy Texts on Public Welfare First-class Guarantee and Public Welfare Second-class Management for Primary Medical and Health Institutions in China from the Perspective of Policy Tools.

• 摘要：目的　分析我国基层医疗卫生机构“公益一类财政保障、公益二类绩效管理”系列政策文本在工具组合、目标匹配与区域结构的差异,为政策的持续优化提供依据。方法　以“基层医疗卫生机构”等作为标题词,“公益一类财政保障、公益二类绩效管理”等作为关键词检索,获取2016-2024年发布的相关政策,基于“政策工具-政策目标-经济区域”的三维分析框架”对74份政策文本量化分析。结果　当前政策工具使用呈现出需求型为主(41.33%),供给型次之(36.66%),环境型(22.02%)较少的结构性特征,且内部的子工具使用存在明显差异；政策目标占比分别为提高基层岗位吸引力(26.13%)、均衡资源配置(19.93%)、促进可持续发展(19.65%)、激发机构运行活力(16.89%)、保障基本运行(12.95%)、明确各方主体责任(4.45%),不同政策目标的实现依赖单一工具；保障基本运行和明确各方主体责任政策目标在各区关注度均不足,中、西部地区需求型工具主要用于提升基层岗位吸引力(41.52%、43.11%),东北地区为实现保障基本运行的目标,对供给型政策工具(30.38%)的依赖较高。结论　四大经济区域在政策工具与目标匹配上存在差异,下一步需强化政策薄弱环节,加强各区域对基本运行保障、明确各方主体责任的关注,并立足区域实际需求优化政策工具组合。

  关键词： 公益一类财政保障、公益二类绩效管理; 基层医疗卫生机构; 政策工具

   

  Abstract: Objective　To analyze the differences in tool combinations, goal matching, and regional structures of the series of policies on public welfare first-class guarantee and public welfare second-class management , so as to provide a basis for the continuous optimization of policies. Methods　Taking primary medical and health institutions and other terms as the title terms, and public welfare first-class guarantee and public welfare second-class management and other terms as Keywords, relevant policies issued from 2016 to 2024 were retrieved. A quantitative analysis of 74 policy texts was conducted based on the three-dimensional analytical framework of policy tools - policy goals - economic regions. Results　The current policy tools present a structural characteristic dominated by demand-side tools (41.33%), followed by supply-side tools (36.66%), with environment-side tools being the least (22.02%). Meanwhile, significant differences exist in the application of sub-tools within each type of policy tool. The proportions of policy goals were as follows: improving the attractiveness of grassroots positions (26.13%), balancing resource allocation (19.93%), promoting sustainable development (19.65%), stimulating the operational vitality of institutions (16.89%), ensuring basic operation (12.95%), and clarifying the responsibilities of various subjects (4.45%). Different policy goals relied on a single tool for achievement. The policy goals of ensuring basic operation and clarifying the responsibilities of various subjects received insufficient attention in all regions. In central and western regions, demand-type tools were mainly used to achieve the goal of improving the attractiveness of grassroots positions (41.52% and 43.11% respectively), while in the northeast region, there was a high dependence on supply-type policy tools (30.38%) to achieve the goal of ensuring basic operation. Conclusion There are differences in policy tool and goal matching among the four major economic regions. In the next step, efforts should be made to strengthen weak policy links, increase regional attention to basic operational guarantee and the clarification of responsibilities of all stakeholders, and optimize the portfolio of policy tools based on actual regional needs.

  Key words: Public welfare first-class guarantee and public welfare second-class management; Primary medical and health institution; Policy tools

  提交时间：2026-06-08

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• 序号	提交日期	编号	操作
  1	2026-03-24	10.12201/bmr.202606.00022V1	下载

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