基于利益制衡的三医联动系统良性循环模型构建

医疗卫生改革是一个系统工程，医疗机构改革、医疗保险制度改革和药品生产流通改革是该系统的三大组成部分，它们之间相互关联又彼此牵制。通过对该系统相关主体利益、各子系统之间相互关系的分析，采用系统动力学的方法揭示出其目前恶性循环形成的原因，在此基础上构建出三医联动良性循环模型，并提出政府责任到位、建立医疗机构内部激励和约束机制、完善医疗保险制度是三医联动良性循环的突破口。

Virtuous Circle Model of Medical Institutions,Medical Insurance and Drug Industry Co-reform Based on Interest Balancing

The Health System Reform needs the co-reform of medical institutions, medical insurance, and drug industry. Medical institutions subsystem, medical insurance subsystem and drug industry subsystem are interrelated with each other. By analyzing the main stakeholders of the HSR and the relationship between the three subsystems, the paper applies system dynamics to reveal reasons of vicious circle and builds a virtuous cycle. It proposes that the keys to the virtuous cycle are fulfilling government responsibility, establishing internal incentive and restraint mechanisms of medical institutions, and improving medical insurance.