基于扎根理论的基层医疗卫生机构补偿机制及要素探析

补偿机制是决定基层医疗卫生机构改革成功与否的关键。文章以扎根理论的质性研究方法为基础，探索建立基层医疗卫生机构补偿机制的深层次要素。结果发现，补偿机制所涉及的主--素包括政府、基层医疗卫生机构、医务人员和患者四大主体；补偿机制中应包含供给机制、分配机制、监督机制、激励机制四个部分。补偿机制在政府与基层卫生机构的发展之间以中介作用而存在，且对医务人员的行为能够产生直接影响；检验补偿机制是否合理要参照基层医疗卫生机构的发展状况、医务人员满意度和患者满意度的综合评价标准，达到患者满意是补偿机制改革的最终目的。

Analysis of Compensation Mechanism of Primary Health Care Institutions Based on Grounded Theory

T he compensation mechanism is the key point to the reform of primary health care institutions .Based on the qualitative research method of grounded theory ,some deep factors were explored to establish the com-pensation mechanism of primary health care institutions .The result showed that the compensation mechanism includes four main elements ,w hich are government ,primary health care institutions ,medical staffs and pa-tients .The reimbursement mechanism should include supply ,allocation ,supervision ,and motivation .The re-imbursement mechanism plays an intermediary between the government and the primary health care institu-tions ,and can have a direct impact on the medical staffs .To test the rationality of the reimbursement mecha-nism needs to make reference to the development of primary health care institutions ,the medical staff and pa-tient satisfaction as a comprehensive evaluation criterion ;patient satisfaction is the ultimate goal of the reform of the reimbursement mechanism .