A Study On The Effect Evaluation Of The Policy Of "cancelling The Special Account For Community Health Finance" In Beijing

Objective:Review the history policy of the two lines management mechanism of receipts and expenditures of Community health service,analysis the problems and reform of the implementation of the two-line policy in Beijing,By constructing the model of policy effect evaluation,study on the effect of canceling "special financial account"(the two lines management mechanism of receipts and expenditures)of Community Health Services in Beijing by using the method of comparative analysis,to provide some theoretical references for the other areas of the country to discuss abolishing the policy of Community health Finance Special Account.Content:(1)To organize the related policies of the two-line management of Community health service in the country and Beijing,briefly describes the problems faced by the implementation of the two lines management mechanism of receipts and expenditures of the Community health Service organizations in Beijing,the reform scheme and the preliminary results of the pilot area after the Community health finance and the organization status.(2)Building a model of policy effectiveness evaluation:According to the practical purpose of the policy assessment,the objective acquisition model in the effect model of Swedish scholar Vedung is selected as the theoretical basis for the model construction;According to the model theory,use the public policy evaluation framework(policy objectives,policy design and implementation,and the final effect of policies)to set up the logical framework of policy effectiveness evaluation,and identify the main assessment contents;According to the objectives and principles established by the evaluation index,select the specific indicators of each assessment content through literature analysis and literature frequency method,and then determine the final indicators through expert consultation,and establish policy effectiveness evaluation index system;Finally,according to the characteristics of each index,a simple "before and after" comparison analysis is selected as the evaluation method of this study.Methods:It mainly adopts the literature research method,the construction model method and the statistical analysis method.Literature research:through searching CNKIacademic literature database and Wanfang Data,and searching foreign medical literature by PubMed,summarize the community health service institutions' implementation status and reform situation after the implement of the two lines of revenue and expenditure management policy in the national and in beijing,and summarize the experience,achievements and problems in the implementation process.Model construction method:using the effect of Swedish scholars Vedung evaluation model of target acquisition model as the foundation,and using the framework of public policy evaluation(the ultimate ellect of the policy objectives,policy design and implementation,policy),then using the method of literature and expert consultation,establish model and evaluation index system of multi angle of view of political strategy from the target domain.Statistical analysis method:a descriptive statistical analysis was used to carry out an empirical study on the operation status of community health service institutions in Bejing.Conclusion:(1)Policy effect previews after canceling the financial accounts in Beijing:after canceling the community health financial accounts,financial investment in community health was weakened,but the enthusiasm of the community health service institutions was mobilized,operation ability was improved,institutions's operation was security;basic medical service capacity and service efficiency has been improved,but the efficiency of the public health service was needed to improve;the overall satisfaction of medical staff and residents was improved,but the medical staffs working pressure was increasing,the residents' satisfaction of the hospital results was declined.(2)The policy of abolishing the financial accounts' effect evaluation model was established in this study,it's true and feasible,the process is simple and the results are intuitive,evaluation contents is comprehensive and practical is very wide,but the model also has many shortcomings,such as the theory of model selection and the limitations of a single model make the result of policy evaluation one-sided;The indexes in the index system are relatively scattered,and it has not setting index weight for comprehensive evaluation;The time effect of the selected data is not enough,causing the effect and influence of policy not obviously enough.The follow-up study assumes that:on the basis of the model by increasing the incidental effect model to assess the collateral effect of the policy,using a user oriented model to assess whether the policy meets the health needs and expectations of residents and medical staff;Set index weights for each index,to quantitatively and comprehensively evaluate the policy effect;at the same time,extende the policy implementation time for three years,compare and analyze the data of the three years before and after abolishing the policy of Special Finance Account of Community health Service institutions,to draw a more perfect and more accurate conclusion of the policy effect assessment.