Research On The Reimbursement Mechanism Of Zero-profit Drugs Sales Policy For Community Health Care Institutions

To establish and improve the basic health care system, and promote ‖ universal access to basic health services ‖ to achieve the goal, how to improve the compensation system has become a priority among the government’s policies.It is an urgent need to address the problem that what kind of compensation mechanism might be adopted to carry out scientific and effective capital inwestment, and ensure the stable development of basic health care institutions, it is necessary to curb the‖ drug-maintaining-medicine ‖ phenomenon, but also to safeguard the fundamental interests of the medical staff, to attrcut patients to basic health care institutions for treatment, and reduce the burden on patients. Therefore, this study is taking game theory and stakeholder theory as the theoretical basis, combining with cooperative game theory、principal-agent theory、system dynamic method, aiming at lack of investment、unfair distribution、imperfect monitoring system、lack of incentives and other issues in the domestic primary health care institutions compensation mechanism, starting from the mechanism design, through the organic combination of cooperative game theory and stakeholder theory that is the four main interests of government-basic health care institution-medical staff-patient, finds the real interest and needs of each palyer, the system analyzes the intrinstic link between subjects. The main contents are follows:1. The paper summarizes the typical pattern of pharmaceutical reimbursement mechanism in the major developed countries and analyzes the applied conditions, advantages and disadvantages of the typical patterns. It also extracts the thoughts of the pharmaceutical compensation mechanism which is suitable for the reality in China. And it analyzes zero-profit drugs policy reimbursement mechanism modes through four dimensions, namely compensation stamdards、channels、mode and supervision as well as the existing main problems.2. The paper combs and analyzes interests’ game among the main stakeholders of basic health care institutions zero-profit drugs policy reimbursement mechanism based on stakeholders and cooperative game theory and combined with the present situation and characteristics of the base health care insititutions.3. The paper uses system analysis and system dynamics, and builds system dynamics model and mechanism conceptual model of basic health care insititutions zero-profit drugs sale compensation providing a theoretical method and basis for the compensation mechanism improvement.4. Taking the actual situation of Binhai New Area basic health care insititutions for example, analyzing the influence factors of compensation mechanisms, exploring the improving direction and further the content and function of compensation mechanism scientifically to provide theorectical methods and basis for the government who gives reimbursement and guidance for basic health care institutions.Finally, according to the above research, putting forward policy recommendations of improving zero-profit drugs sale compensation mechanism, summarizing the whole content, and pointing out the direction and focus of the further study.