不同举办形式社区卫生服务机构运行机制研究
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摘要
研究目的
通过对不同举办形式社区卫生服务机构在既定运行模式下的功能实现情况进行比较,分析举办形式和运行机制相关要素对机构功能实现的影响,为改革和完善社区卫生服务机构运行机制提供参考,并就推进社区卫生综合改革提出相关政策建议。
研究方法
采用文献研究,收集整理社区卫生服务有关政策、理论研究、实践进展、现况调查和课题研究报告等资料,分析社区卫生运行机制有关理论成果和实践经验。采用现况调查和SWOT分析等方法,研究不同举办形式社区卫生服务机构的特点,分析社区卫生运行机制有关要素的优势和挑战。采用卡方检验、秩和检验、多元线性回归分析等方法,分析举办形式和运行机制相关要素对社区卫生服务机构功能实现的影响。
研究结果
对社区卫生有关资料进行研究,并选取6个社区卫生服务体系建设重点联系城市444所社区卫生服务中心的2009年常规监测数据进行分析。结果显示,运行机制相关要素中的收支两条线管理、纳入医保定点、药品零差率销售和举办形式对基本公共卫生服务项目开展率的影响有统计学意义(p＜0.05)；独立法人、医保定点、药品零差率销售、收支两条线管理以及药品配备数量、临床医师数、床位数等因素对服务量影响有统计学意义(P＜0.05)。实行收支两条线管理、药品零差率销售、绩效工资对服务效率的影响有统计学意义(P＜0.05)。将单因素统计有意义的因素纳入多元线性回归分析模型,结果显示,机构年门诊量受独立法人、收支两条线管理等因素的影响(回归模型F=223.41,P＜0.0001)；居民建档量受第一名称注册、药品配备数量、临床医师数影响(回归模型F=119.54,P<0.0001)；免疫接种量受独立法人、收支两条线管理等因素影响(回归模型F=116.40,P<0.0001)；儿童保健量受独立法人、收支两条线管理等因素的影响(回归模型F=41.62,P<0.0001)；高血压管理量受第一名称注册、药品零差率销售等因素的影响(回归模型F=50.48,P<0.0001)；医生人均年门诊量受收支两条线管理等因素的影响(回归模型F=71.75,P<0.0001)；居民建档率受药品配备数量、绩效工资管理等因素的影响(回归模型F=174.96,P<0.0001)；规划内免疫接种比例受收支两条线管理、药品配备数量的影响(回归模型F=73.93,P<0.0001)。
以举办形式和运行机制关键要素为依据对既定运行模式社区卫生服务机构功能实现情况进行分析。举办形式、机构性质、收支两条线管理对既定运行模式下的社区卫生服务机构功能实现有显著性影响(P值均小于0.05)；绩效工资对政府办、差额拨款、实行收支两条线管理的社区卫生服务机构功能实现无显著性影响(P>0.05)。
研究结论
社区卫生服务机构的功能实现受举办形式和运行机制相关要素等诸多因素的影响,且不同服务指标的影响因素各异。举办形式对社区卫生服务机构功能实现有显著性影响,政府办的社区卫生服务机构的基本公共卫生服务开展率和门诊量均高于医院办和企业办机构,但在既定运行模式下,政府办与医院办的机构在医疗服务效率和基本公共卫生服务方面并没有显著性差异。实行收支两条线管理可以有效促进社区卫生服务机构的功能实现。在政府办或医院办、差额拨款、是否实行绩效工资等方面具有相同特征的机构中,实行收支两条线管理的机构在服务量和工作效率方面均明显好于未实行收支两条线管理的机构,显示无论是政府办还是医院办的机构,实行收支两条线管理后,并没有出现养懒人、低效率的现象。
因此,应坚持政府主导,鼓励社会参与,对不同举办形式的机构一视同仁,切实把社区卫生工作重点放在完善政策措施,落实经费补助,加强对机构的绩效考核与服务监管等方面,发挥不同举办形式社区卫生服务机构的作用。积极推进社区卫生综合改革,在完善经费投入、人事分配、药品零差率销售和基本公共卫生服务经费补助机制、绩效考核等配套政策的基础上,稳步推行收支两条线管理,维护社区卫生服务机构公益性质。
Objective:
The impact of relevant factors, associated with the operational mechanism and the ownerships, on the CHS institutions performing functions were analyzed through comparing how the CHS institutions with different ownerships fulfilled their functions under given operational mechanism models. It aims at providing guidance for reforming and improving the operational mechanism of CHS institutions and putting forward relevant policy recommendations for pressing ahead comprehensive reform of community health.
Contents and methods:
Policies, theoretical studies, practice progress, field survey and research reports associated with community health services were collected and collated by use of literature searching method, so as to analyze the theoretical outcomes and practice experiences in relation to the operational mechanism of community health.. The field survey and SWOT technology were adopted to study the characteristics of CHS institutions with different ownerships, and analyze the advantages and challenges facing the elements corresponding to the operational mechanism of community health. Chi-square test, Rank Sum test and Multiple Linear Regression analysis were applied to analyze how the factors relevant to different ownerships and operational mechanism models affect CHS institutions performing their functions.
Results:
Through analyzing the regular monitoring data of 444 CHS centers in six key liaison cities of the Establishment Program of CHS System, aside from studying other materials related to community health, following outcomes were found:1)among all the factors related to the operational mechanisms, implementation of Separation from Revenues and Expenditures Budget Management, CHS institutions being covered by the health insurance agencies, CHS institutions selling medicines with Zero-Margin profits and the ownerships of CHS institutions were significantly associated with the provision rates of essential public health service programs (p<0.05); 2)such characteristics as being independent enterprises, being covered by the health insurance agencies, selling medicines with Zero-Margin profits, implementing Separation from Revenues and Expenditures budget management, number of equipped medicines, number of clinical physicians, and number of beds for CHS institutions were significantly correlated with the service quantity (P<0.05); 3) implementating Separation from Revenues and Expenditures budget management and performance-based payment, and selling medicines with Zero-Margin profits were significantly associated with the working efficiency (P<0.05). Through Multiple linear regression analysis by including all the independent variables that were significantly associated with respective dependent variables, it demonstrated that the number of outpatient visits was affected by the factors as being independent enterprises and implementing Separation from Revenues and Expenditures budget management (F=223.41, P<0.0001); the number of established health records for residents was affected by such factors as the first registered title of community health institutions, and the number of equipped medicines and clinical physicians (F=119.54, P<0.0001); the number of immunization injections was influenced by such factors as being independent enterprises and implementation of Separation from Revenues and Expenditures budget management (F=41.63, P<0.0001); the volume of child care was affected by such factors as being independent enterprises and implementation of Separation from Revenues and Expenditures budget management (F=41.62, P<0.0001); the number of managed patients with hypertension was affected by such factors as the first registered title and selling medicines with Zero-margin Profits (F=50.48, P<0.0001); the average number of outpatient visits per physician was affected by such factor as implementation of Separation from Revenues and Expenditures budget management (F=71.75, P<0.0001); the rate of establishing residents' health records was affected by such factors as the number of equipped medicines and implementation of performance-based payment (F=174.96, P<0.0001); the proportion of planned immunization injection was influenced by such factors as implementation of Separation from Revenues and Expenditures budget management and the number of equipped medicines (F=73.93, P<0.0001). Basing on the ownerships and the key factors related to the operational mechnisms, the status of CHS institutions performing their functions under given operational models were analyzed. The ownerships, attributes of CHS institutions and implementation of Separation from Revenues and Expenditures budget management were significantly associated with CHS institutions performing their functions under the givern operational models (all the P values were less than 0.05). The performance-based payment was not significantly associated with the government-owned CHS institutions (in which, Separation from Revenues and Expenditures Budget management and Balance Allocation policy were implemented too) performing their functions (P>0.05).
Conclusions:
Whether community health services fulfil their functions is affected by many factors associated with the ownerships and operational mechanisms, and the impact varied across different service indicators. Generally, the type of ownerships had significant impact on CHS institutions performing their functions. The state-owned CHS institutions had better performance in terms of the provision rates of essential public health services and the number of outpatient visits, if compared with those governed by the hospitals and enterprises. However, under some specific operationals models, no significant difference, in terms of medical service efficiency and essential public services delivery, was observed between the govern-owned and hospital affiliated CHS institutions. Implementation of Separation from Revenues and Expenditures budget management could efficiently promote CHS institutions to fulfil their functions. With the similar factors as implementing the Balance Allocation policy and performance-based payment, both the government-owned and the hospital-owned CHS institutions provided better service quantity and efficiency than their counterparts through implementing Separation from Revenues and Expenditures budget management. This demonstrated that, health professionals didn't become lazy and the service efficiency didn't decrease either in both the government-owned and the hospital affiliated CHS institutions after implementing Separation from Revenues and Expenditures budget management. Thus, emphasis should be placed on the government playing the leading role, encouraging social participation, treating all the CHS institutions with different ownerships equally, as well as attaching the importance to improving the policies, enforcing the reimbursement policy, and enhancing institutional performance evaluation and service monitoring and management, so as to enable all the CHS institutions to play their full roles. Besides, it necessitates pressing ahead the comprehensive reforms on community health actively. On basis of improving such policies as public input, human resources system and bonus allocation, Pharmaceutic Zero-margin profits, reimbursement mechanism for public health services, Separation from Revenues and Expenditures budgets management.
通过对不同举办形式社区卫生服务机构在既定运行模式下的功能实现情况进行比较,分析举办形式和运行机制相关要素对机构功能实现的影响,为改革和完善社区卫生服务机构运行机制提供参考,并就推进社区卫生综合改革提出相关政策建议。
研究方法
采用文献研究,收集整理社区卫生服务有关政策、理论研究、实践进展、现况调查和课题研究报告等资料,分析社区卫生运行机制有关理论成果和实践经验。采用现况调查和SWOT分析等方法,研究不同举办形式社区卫生服务机构的特点,分析社区卫生运行机制有关要素的优势和挑战。采用卡方检验、秩和检验、多元线性回归分析等方法,分析举办形式和运行机制相关要素对社区卫生服务机构功能实现的影响。
研究结果
对社区卫生有关资料进行研究,并选取6个社区卫生服务体系建设重点联系城市444所社区卫生服务中心的2009年常规监测数据进行分析。结果显示,运行机制相关要素中的收支两条线管理、纳入医保定点、药品零差率销售和举办形式对基本公共卫生服务项目开展率的影响有统计学意义(p＜0.05)；独立法人、医保定点、药品零差率销售、收支两条线管理以及药品配备数量、临床医师数、床位数等因素对服务量影响有统计学意义(P＜0.05)。实行收支两条线管理、药品零差率销售、绩效工资对服务效率的影响有统计学意义(P＜0.05)。将单因素统计有意义的因素纳入多元线性回归分析模型,结果显示,机构年门诊量受独立法人、收支两条线管理等因素的影响(回归模型F=223.41,P＜0.0001)；居民建档量受第一名称注册、药品配备数量、临床医师数影响(回归模型F=119.54,P<0.0001)；免疫接种量受独立法人、收支两条线管理等因素影响(回归模型F=116.40,P<0.0001)；儿童保健量受独立法人、收支两条线管理等因素的影响(回归模型F=41.62,P<0.0001)；高血压管理量受第一名称注册、药品零差率销售等因素的影响(回归模型F=50.48,P<0.0001)；医生人均年门诊量受收支两条线管理等因素的影响(回归模型F=71.75,P<0.0001)；居民建档率受药品配备数量、绩效工资管理等因素的影响(回归模型F=174.96,P<0.0001)；规划内免疫接种比例受收支两条线管理、药品配备数量的影响(回归模型F=73.93,P<0.0001)。
以举办形式和运行机制关键要素为依据对既定运行模式社区卫生服务机构功能实现情况进行分析。举办形式、机构性质、收支两条线管理对既定运行模式下的社区卫生服务机构功能实现有显著性影响(P值均小于0.05)；绩效工资对政府办、差额拨款、实行收支两条线管理的社区卫生服务机构功能实现无显著性影响(P>0.05)。
研究结论
社区卫生服务机构的功能实现受举办形式和运行机制相关要素等诸多因素的影响,且不同服务指标的影响因素各异。举办形式对社区卫生服务机构功能实现有显著性影响,政府办的社区卫生服务机构的基本公共卫生服务开展率和门诊量均高于医院办和企业办机构,但在既定运行模式下,政府办与医院办的机构在医疗服务效率和基本公共卫生服务方面并没有显著性差异。实行收支两条线管理可以有效促进社区卫生服务机构的功能实现。在政府办或医院办、差额拨款、是否实行绩效工资等方面具有相同特征的机构中,实行收支两条线管理的机构在服务量和工作效率方面均明显好于未实行收支两条线管理的机构,显示无论是政府办还是医院办的机构,实行收支两条线管理后,并没有出现养懒人、低效率的现象。
因此,应坚持政府主导,鼓励社会参与,对不同举办形式的机构一视同仁,切实把社区卫生工作重点放在完善政策措施,落实经费补助,加强对机构的绩效考核与服务监管等方面,发挥不同举办形式社区卫生服务机构的作用。积极推进社区卫生综合改革,在完善经费投入、人事分配、药品零差率销售和基本公共卫生服务经费补助机制、绩效考核等配套政策的基础上,稳步推行收支两条线管理,维护社区卫生服务机构公益性质。
Objective:
The impact of relevant factors, associated with the operational mechanism and the ownerships, on the CHS institutions performing functions were analyzed through comparing how the CHS institutions with different ownerships fulfilled their functions under given operational mechanism models. It aims at providing guidance for reforming and improving the operational mechanism of CHS institutions and putting forward relevant policy recommendations for pressing ahead comprehensive reform of community health.
Contents and methods:
Policies, theoretical studies, practice progress, field survey and research reports associated with community health services were collected and collated by use of literature searching method, so as to analyze the theoretical outcomes and practice experiences in relation to the operational mechanism of community health.. The field survey and SWOT technology were adopted to study the characteristics of CHS institutions with different ownerships, and analyze the advantages and challenges facing the elements corresponding to the operational mechanism of community health. Chi-square test, Rank Sum test and Multiple Linear Regression analysis were applied to analyze how the factors relevant to different ownerships and operational mechanism models affect CHS institutions performing their functions.
Results:
Through analyzing the regular monitoring data of 444 CHS centers in six key liaison cities of the Establishment Program of CHS System, aside from studying other materials related to community health, following outcomes were found:1)among all the factors related to the operational mechanisms, implementation of Separation from Revenues and Expenditures Budget Management, CHS institutions being covered by the health insurance agencies, CHS institutions selling medicines with Zero-Margin profits and the ownerships of CHS institutions were significantly associated with the provision rates of essential public health service programs (p<0.05); 2)such characteristics as being independent enterprises, being covered by the health insurance agencies, selling medicines with Zero-Margin profits, implementing Separation from Revenues and Expenditures budget management, number of equipped medicines, number of clinical physicians, and number of beds for CHS institutions were significantly correlated with the service quantity (P<0.05); 3) implementating Separation from Revenues and Expenditures budget management and performance-based payment, and selling medicines with Zero-Margin profits were significantly associated with the working efficiency (P<0.05). Through Multiple linear regression analysis by including all the independent variables that were significantly associated with respective dependent variables, it demonstrated that the number of outpatient visits was affected by the factors as being independent enterprises and implementing Separation from Revenues and Expenditures budget management (F=223.41, P<0.0001); the number of established health records for residents was affected by such factors as the first registered title of community health institutions, and the number of equipped medicines and clinical physicians (F=119.54, P<0.0001); the number of immunization injections was influenced by such factors as being independent enterprises and implementation of Separation from Revenues and Expenditures budget management (F=41.63, P<0.0001); the volume of child care was affected by such factors as being independent enterprises and implementation of Separation from Revenues and Expenditures budget management (F=41.62, P<0.0001); the number of managed patients with hypertension was affected by such factors as the first registered title and selling medicines with Zero-margin Profits (F=50.48, P<0.0001); the average number of outpatient visits per physician was affected by such factor as implementation of Separation from Revenues and Expenditures budget management (F=71.75, P<0.0001); the rate of establishing residents' health records was affected by such factors as the number of equipped medicines and implementation of performance-based payment (F=174.96, P<0.0001); the proportion of planned immunization injection was influenced by such factors as implementation of Separation from Revenues and Expenditures budget management and the number of equipped medicines (F=73.93, P<0.0001). Basing on the ownerships and the key factors related to the operational mechnisms, the status of CHS institutions performing their functions under given operational models were analyzed. The ownerships, attributes of CHS institutions and implementation of Separation from Revenues and Expenditures budget management were significantly associated with CHS institutions performing their functions under the givern operational models (all the P values were less than 0.05). The performance-based payment was not significantly associated with the government-owned CHS institutions (in which, Separation from Revenues and Expenditures Budget management and Balance Allocation policy were implemented too) performing their functions (P>0.05).
Conclusions:
Whether community health services fulfil their functions is affected by many factors associated with the ownerships and operational mechanisms, and the impact varied across different service indicators. Generally, the type of ownerships had significant impact on CHS institutions performing their functions. The state-owned CHS institutions had better performance in terms of the provision rates of essential public health services and the number of outpatient visits, if compared with those governed by the hospitals and enterprises. However, under some specific operationals models, no significant difference, in terms of medical service efficiency and essential public services delivery, was observed between the govern-owned and hospital affiliated CHS institutions. Implementation of Separation from Revenues and Expenditures budget management could efficiently promote CHS institutions to fulfil their functions. With the similar factors as implementing the Balance Allocation policy and performance-based payment, both the government-owned and the hospital-owned CHS institutions provided better service quantity and efficiency than their counterparts through implementing Separation from Revenues and Expenditures budget management. This demonstrated that, health professionals didn't become lazy and the service efficiency didn't decrease either in both the government-owned and the hospital affiliated CHS institutions after implementing Separation from Revenues and Expenditures budget management. Thus, emphasis should be placed on the government playing the leading role, encouraging social participation, treating all the CHS institutions with different ownerships equally, as well as attaching the importance to improving the policies, enforcing the reimbursement policy, and enhancing institutional performance evaluation and service monitoring and management, so as to enable all the CHS institutions to play their full roles. Besides, it necessitates pressing ahead the comprehensive reforms on community health actively. On basis of improving such policies as public input, human resources system and bonus allocation, Pharmaceutic Zero-margin profits, reimbursement mechanism for public health services, Separation from Revenues and Expenditures budgets management.
引文
[1]Gastel BA, Wilson MP, Boelen C. Toward a global consensus on quality medical education:serving the needs of populations and individuals. AcadMed,1995, 70 (7 Suppl):73275.
[2]Franks P, Fiscella K. Primary care physicians and specialists as personal physicians. Health care expenditures and mortality Experience. J Fam Pract,1998,47:1052109.
[3]闵维方等.高等教育运行机制研究[M].人民教育出版社,2002,6：66-90.
[4]王玉环,张亮.社区卫生服务运行机制的理论探究[J],中国卫生事业管理,2006,213 (3):189-191.
[5]Orton P, Fry J. UK Health Care:The Facts [M]. Kluwer Academic Publishers, 1995.36.123.
[6]Clark NM. Community/practice/academic partnerships in public health[J]. Am J Prev Med,1999,16(Suppl3):18-19.
[7]O Martin JC. Avant RF, Bowman MA, etal. The Future of Family Medicine: A collaborative Project of the Family Medicine Community[J]. Annals of Family Med,2004,2(Suppl1):S3-S32.
[8]靳清汉,唐长冬,常振华,等.中医投人与卫生筹资关系探讨[J],中医药管理杂志,2009,17 (12):1113-1114.
[9]仇元峰,张鹭鹭,田伟,等.国内外社区卫生服务发展模式比较[J].中国全科医学,2006,9(17)：1398—1400.
[10]姚岚,陈子敏,陈启鸿,等.实现政府购买建立可持续社区卫生服务筹资机制.中华医院管理杂志,2007,21(10)：654-657.
[11]王梅,徐国桓,张路,等.社区卫生服务筹资与补偿机制的探讨[J].中华医院管理杂志.2000,16(7)：409-412
[12]刘朝杰.澳大利亚的卫生体制与卫生政策[J],中国全科医学,2004,7(21)：1545—1548.
[13]Guy Carrin, Maria-Pia Waelkens, Bart Criel. Community-based health insurance in developing countries:a study of its contribution to the performance of health financing systems [J]. Tropical Medicine and International Health.2005 August,10(8):799-811.
[14]卢祖洵,金生国.国外社区卫生服务[M].人民卫生出版社,2001,10：6-10.
[15]Orchard J. Community development and health in Canada [J]. nurs-Scholarsh, 2000,32(2):205-206.
[16]MINISTRY OF HEALTH(1999a). Health Expenditure Trends in New Zealand 1980-1998[R]. Wellington:Government Printer,.
[17]Eggleston K, Li L, Meng Q, et al. Health service delivery in China:A literature review. World Bank Policy Working Paper,2006.3978.
[18]王枫叶.浅谈政府在社区卫生服务筹资中的作用[J].中国社会医学杂志,2007(04)：224-226.
[19]何国忠,罗五金.政府投入方式对社区卫生服务中心完成公共卫生功能的影响分析[J].医学与社会,2006,(03)：54-57.
[20]Laura Cabiedes, Ana Guillen. Adopting and adapting managed competition: health care reform in southern Europe [J]. Social Science & Medicine,2001(52)：1205-1217.
[21]刘昆仑.政府购买公共服务在卫生服务领域的可行性探讨[J].中国卫生经济,2009,28 (1):7-9.
[22]Natasha Palmer. The use of private—sector contracts for primary health care:theory, evidence and lessons for low-income and middle-income countries[J]. Bulletin of the WOrld Health Organization,2000,78(6):821—826.
[23]Alexander S, Preker, April Harding. "Make or Buy" decisions in the production of health care goods and service:new insights from institutional economics and organizational theory[J]. Bulletin of the World Health Organization,2000,78(6):779-788.
[24]William Jack. Optimal risk adjustment with adverse selection and spatial competition[J]. Journal of Health Economics,2005, (25):908-926.
[25]Cutler D. Equality, Efficiency, Market. Fundamentals:The dynamics of international medical care[J]. Journal of Economics Literature,2002, 40 (3):881-906.
[26]Castledine G. Can performance- related pay be adapted for nursing? British Journal of Nursing 1993,2(22):1120-1121.
[27]Buchan J. and Thompson M.. Pay and nursing performance. Health Manpower Management 1993,19(2):29-31.
[28]Chapin J, Fetter B Performance- based contracting in Wisconsin public health:transforming state- local relations. Milbank Q.2002,80(1):97-124.
[29]孟庆跃.医疗保险支付方式改革对费用控制的影响分析.卫生经济研究,2002,(9):18-21.
[30]傅家康.社区卫生服务机构收支两条线改革的实践及思考[J].卫生经济研究,2007, (2):51-52.
[31]1 White, Peter, William. Rural Workforce Agencies Minimum Data Set Report as at 30 November 2004:7.
[32]Ulmer B, Harris M'Australian GP are satisfied with their job:even more so in rural areas. Fam Pract,2002,19(3):300-3.
[33]Anell A. Persson M. Intemational comparisons ofhealth care resouTces. L akartidningen,1998,95(30-31):3315-8.
[34]Y. Zhao, S. Cui, J. Yang, etal. Basic public health services delivered in an urban community:a qualitative study[J]. public health.2010,125(2011)37-45.
[35]Pei L, Stanton P, Legge D Improving human resource management in Chinese heath care:identifying the obstacles to change, Australian Health Review, 2004,27:124-130.
[36]姚岚,龚勋,熊巨洋等.社区卫生服务中心个人绩效考核方案初探[J].中国卫生经济,2006,26(12)：13-15.
[37]李芳.我国人事制度改革的哲学反思[J].理论探讨.2001(3)：33—34.
[38]尤川梅,姚岚,王芳,等.“定编、定岗、不定人”收支两条线管理下社区卫生服务机构的人事制度设计[J],中国卫生经济,2010(323)：70-73.
[39]Pei L. Legge D, Stanton P Policy contradiction limiting hospital performance. Policy Studies,2000,21:99-114.
[40]Huey-Ming Tzeng, Shake Ketefian, Richand w. Redman. Relationship of nurses assessment of organizational culture, job satisfaction and patient satisfaction with nursing care. International journal of nursing studies, 2003,39:79-84
[41]Haas JS, Cook EF, Puopolo RL, etc. Is the professional satisfaction of general intermits associated with patient satisfaction? J Gen Intern Med,2000,15：122-128
[42]刘朝杰,李伟,姚岚.澳大利亚的社区卫生服务与全科医疗对中国的影响和蕴义[J].中国全科医学杂志,2004 7(21),1545-1550.
[43]陈霞.社区卫生服务模式的思考[J].中国社区医师,2005,18(3)：4-5.
[44]Gomez-Mejia L R. Structure and process of diversification compensation strategy and firm performance [J]. Strategic Management Journal,1992 (10):21-25.
[45]Robbins S P. Personnel:The Management of Human Resources [R].2004.
[46]李华任,荣伟.360度绩效评估法的运用及有效性分析[J].现代管理科学,2004,8:33-34.
[47]Virginia Department of Planning and Budget. Virginia's Handbook on Planning and Performance [M]. Virginia Department of Planning and Budget,1998.
[48]刘运国、张亮.初级卫生保健机构绩效评价[M].北京：中国财政经济出版社,2007.
[49]PauL A, Lamarche. Marie-dominique beaulieu, raynald pineault. choice for change [R]. The restructuring primary healthcare service in Canada,2004.
[50]Developing Ontario's health system performance management scorecard. Health care:New research, new priorities new directions [R]. January2006.
[51]Primary care for children. Primary care in Ontario[R]. Institute for clinical evaluation science,2004.
[52]Martinc Misener R, McNab J, Sketris IS, et al. Collaborative practice in health systems change:The Nova Scotia experience with the Strengthening Primary Care Initiative[J]. Can J Nurs Leadership,2004 May; 17(2):33-45.
[53]Diane EW, Anne-marie B, Robert JR. A results-based logic model for primary health care. Laying an evidence -based foundation to guide performance, monitoring and evaluation [R]. College of health disciplines, the university of British Columbia, 2004.
[54]樊延军,刘朝杰.澳大利亚社区卫生服务系统评审项目对我国社区卫生服务的借鉴价值[J].中国全科医学,2007,10(20)：1704-1705.
[55]刘运国,张亮,等.初级卫生保健机构绩效评价[M].北京：中国财政经济出版社, 2007.
[56]庄霞,尹爱田,任绪功,等.构建综合医院绩效评价关键指标体系的研究[J].中华医院管理杂志,2006,5(6)：341-344.
[57]Milton I. Roemer, Ruth J. Roemer. Health Care Systems and Comparative Manpower Policies, Leichter Journal of Health Politics, Policy and Law.1982,7:532-534.
[58]王芳,张全红,金建强等,社区卫生服务绩效评价指标体系的信度与效度评价[J].中国全科医学,2008,1A(11)：77-79.
[59]Church A H, Bracken D W. Advancing the State of the Art of 360 Degree Feedback[J]. Group & Organization Management,1997,22 (2):149-161.
[60]NICE clinical guideline.hypertention:Management of hypertension in adults in primary care[R]. National institute for health and clinical excellence,2004.
[61]刘毅俊,李滔,朱宏斌等.对武汉市社区卫生服务中心医药分开改革的情况分析与思考[J].中国卫生事业管理,2007, (3)：204-205.
[62]王铮,陈瑶,王峥等.社区卫生服务机构零差率药品断货现象分析[J].中国卫生经济,2008,27(7)：22-24.
[63]陈铮,高军.社区药品“零差率”任重道远——冷观社区卫生服务药品集中采购和集中配送[J].首都医药,2007(3)：15-19.
[64]张忠霖,张建萍,朱学德.SWOT分析法与医院管理理论探讨[J].中国医院,2002,7(5)：15-17.
[65]雷海潮,吴国安,刘金峰,等.加入WTO后我国公立医院发展的SWOT分析[J].中国医院管理,2002,22(2)：1
[66]樊立华,户宏艳,李莉等.不同举办形式开展社区卫生服务的SWOT分析[J]中国农村卫生事业管理,2007,27(2)：107-109.
[67]Leibenstein H. The theory of underemployment in densely populared backward areas, in Harvey leibenstein, (ed), economic backwardness and economic growth[M]. New York:John Wiley & Sons,1963.
[68]Lardy N. Economic growth and distribution in China. New York:Cambridge University Press.1999,50.
[69]Pei L. Hospital management in a time of change:the need for management training (and policy reform) in three teaching hospitals in Yunnan. UMI: A Bell & Howell Company, Ann Arvor, Michigan,1998.30-32
[70]Duckett SJ. The Australian health care system (2nd edition), Oxford University Press, Oxford,59.
[71]Helen P. Bartlett. Community health policy and provision in Hong Kong: challenges for 1997 and beyond. Health & Place, Vol.1, No.4, pp.243-249, 1995.
[72]Fine MD. Coordinating health, extended care, and community support services:reforming aged care in Australia. Journal ofAging&Social Policy,1999.11(1):67-90.
[1]Hall J J, Taylor R. Health for all beyond 2000:the demise of the AL -ma Ata Declaration and primary health care in developing countries [J]. MJA,2003,178 (1):17-20.
[2]马鸣,尤川梅,姚岚.促进大型企业医院转型社区卫生服务的发展[J].中国卫生经济,2006,26(11)：51-53.
[3]王枫叶.政府主导下的社区卫生服务市场化管理模式[J].中国初级卫生保健,2008,22(4)：23-25.
[4]刘毅俊,李滔,邹吉更等.加大社区卫生服务经费投入推进其可持续发展[J].中国卫生经济,2007,26(9)：34.
[5]韩方群.中澳社区卫生服务的比较及启示[J].1中国全科医学,2005,8：1506.
[6]陈渊青,罗乐宣,王跃平,等1国内外社区卫生服务的进展[J].中国全科医学,2004,7:1098.
[7]仇元峰,张鹭鹭,田伟等.国内外社区卫生服务发展模式比较[J].中国全科医学,2006,9(17)：1397-1398.
[8]张莹,苏珍玲,周彬,等.中澳社区卫生服务比较与启迪[J].现代预防医学,2003,30 (4):589-592.
[9]张愈.开展区域卫生规划进行卫生资源调整积极探索社区卫生服务发展新思路[J].中华医院管理杂志,2005,21(5)：289-292.
[10]庞连智,祝友元,贺金仙,等.上海城市社区卫生服务中心资产委托经营管理改革研究[J]. 解放军医院管理杂志,2004,11(5)：446-447.
[11]葛敏,江萍,赵晓明.社区卫生服务发展中的政府主导作用[J].中国卫生经济,2007,26 (9):29-31.
[12]王光荣,詹绍康,郭怀保等.上海市闸北区社区卫生服务管理体制改革研究概述[J].中华医院管理杂志,2005,21(8)：509-513.
[13]任涛,胡永华.对当前社区卫生服务中面临问题的几点思考[J].中国公共卫生管理,2007,23(6)：567-568.
[14]迟玉聚,姚岚,张丽芳.民营社区卫生服务发展的优势与挑战[J].中国卫生经济,2007,26(12)：10-12.
[15]尤川梅, 舒展, 易春黎等.企事业医疗机构转型社区卫生服务的居民满意度调查[J].中国卫生经济,2008,27(1)：51-54.
[16]骆亮,陈颖姣.双向转诊制度实施问题研究[J].卫生经济研究,2006,(11)：46-47
[17]卢杨,张鹭鹭,马玉琴,等.医院与社区卫生服务互动的影响因素分析与对策研究[J].中国全科医学杂志,20091 2(2A),206-207.
[18]卢祖洵,刘军安,彭绩等.深圳市社区卫生服务利用及其影响因素分析[J].中华医院管理杂志,2005,21(7)：464-467
[19]陈子敏,王光荣,陈启鸿等.实现政府购买建立可持续性社区卫生服务筹资机制[J].中华医院管理杂志,2005,21(10)：654-657.
[20]邹宗峰,邹宇华,张瑛等.城市社区公共卫生服务优先项目的筛选方法和补偿机制研究[J].中国卫生经济,2009,28(1)：58-60.
[21]徐林山,程晓明,周召梅等.城市社区公共卫生服务项目分类研究[J].中华医院管理杂志,2005,21(2)：86-88.
[22]尹爱田,俞水,杨百团,等.基层卫生机构功能定位和财政投入机制[J].中国卫生经济,2007,26(12)：86-88.
[23]朱骥,王光荣,李哲等.社区卫生服务授权经营改革对服务提供的影响[J].中华医院管理杂志,2005,21(8)：513-515.
[24]沈慰如.对政府购买社区公共卫生产品的设想[J].卫生经济研究,2004,(9)：15-16.
[25]何国忠,罗五金,姚岚等.政府投入方式对社区卫生服务中心完成公共卫生功能的影响分析[J].医学与社会,2006,19(3)：54-56.
[26]张媚,景琳,李玉强等.从成本测算结果探讨政府购买模式下的社区公共卫生服务财政补偿[J].中国卫生经济,2009,28(1)：46-48.
[27]江萍.对政府购买社区公共卫生服务的探索[J].上海预防医学杂志,2002,14(5)：243.
[28]徐林山,程晓明,朱坤等.四城市社区公共卫生服务项目成本测算[J].中国卫生经济,2005,24(7)：37-39.
[29]姚岚,陈启鸿,林玲等.实现社区卫生服务机构内部市场化运作[J].中华医院管理杂志,2005,21(10)：657-659.
[30]张成勉, 孙永发, 吴华章.我国社区卫生服务中政府购买公共卫生服务项目的难点和建议[J].中国卫生经济,2009,28(1)：44-45.
[31]Laura Cabiedes, Ana Guillen. Adopting and adapting managed competition: health care reform in southern Europe [J]. Social Science & Medicine,2001 (52):1205-1217.
[32]刘昆仑.政府购买公共服务在卫生服务领域的可行性探讨[J].中国卫生经济,2009,28(1)：7-9.
[33]William Jack. Optimal risk adjustment with adverse selection and spatial competition[J]. Journal of Health Economics,2005, (25):908-926.
[34]Cutler D. Equality, Efficiency, Market. Fundamentals:The dynamics of international medical care[J]. Journal of Economics Literature,2002, 40 (3):881-906.
[35]郑红,郭亚军, 曾华.基于期权理念的国家基本医疗卫生服务管理模式研究[J].中国卫生经济,2009,28(3)：5-7.
[36]傅鸿鹏,何倩,俞金枝等.看病难看病贵研究的文献评价[J].中华医院管理杂志,2006,22(10)：701-704.
[37]Buchan J. Performance- related pay and NHS nursing. Nurs. Stand.1993, 7(25):30.
[38]Castledine G. Can performance- related pay be adapted for nursing? British Journal of Nursing 1993,2(22):1120-1121.
[39]Buchan J. and Thompson M.. Pay and nursing performance. Health Manpower Management 1993,19(2):29-31.
[40]Chapin J, Fetter B Performance-based contracting in Wisconsin public health:transforming state-local relations. Milbank Q.2002,80(1):97-124.
[41]Kouides RW et al. A performance-based incentive program for influenza immunization in the elderly. Am J Prev Med.1993 Jul-Aug 9(4):250-255.
[42]Kouides RW et al. Performance-based physician reimbursement and influenza immunization rates in the elderly. The Primary-Care Physicians of Monroe County. Am J Prev Med 1998 Feb 14 (2):89-95.
[43]Leese B and Bosanquet N Changes in general practice organization:survey of general practitioners' views on the 1990 contract and fundholding. Br J Gen Pract.1996,46 (403):95-99.
[44]孟庆跃.医疗保险支付方式改革对费用控制的影响分析.卫生经济研究,2002,(9)：18-21.
[45]宫习飞,于保荣,袁蓓蓓,等.基层卫生服务机构支付方式研究[J].中华医院管理杂志,2007,26(9)：54-56.
[46]陈娜,冯国忠.单病种限价的SWOT分析及对策研究[J].西部药学,2007,4(3)：144-146.
[47]洪哲芳,程晓明,赵大海等.山西省和顺县“合同购买卫生服务”项目评价[J].中国卫生经济,2008,27(3)：45-46.
[48]王万荣,何晓琦,陈叶纪.合同购买重点卫生服务试点研究[J].中华医院管理杂志,2006 22(12),799-802.
[49]马亚娜,翁开源,宋雪佳等.不同城市社区卫生服务人力资源的比较研究[J]. 中国卫生事业管理,2004,(5)：286-288.
[50]张泽,祁素文.国外社区卫生服务现况及启示[J].中国全科医学杂志,20058(16),1283-1284.
[51]张跷玲,李红玉.澳大利亚的社区卫生服务模式对中国全科医学教育的启示[J].中国卫生事业管理,2004,(2)：99-101.
[52]傅家康.社区卫生服务机构收支两条线改革的实践及思考[J].卫生经济研究,2007, (2):51-52.
[53]李再强,林枫.国外社区首诊制度简介[J].中国卫生经济,2006,25(2):76-77.
[54]NICE clinical guideline. hypertention:Management of hypertension in adults in primary care[R]. National institute for health and clinical excellence,2004.
[55]姚岚,龚勋,熊巨洋等.社区卫生服务中心个人绩效考核方案初探[J].中国卫生经济,2006,26(12)：13-15.
[56]Huey-Ming Tzeng, Shake Ketefian, Richand w. Redman. Relationship of nurses assessment of organizational culture, job satisfaction and patient satisfaction with nursing care. International journal of nursing studies,2003,39：79-84
[57]Haas JS, Cook EF, Puopolo RL, etc. Is the professional satisfaction of general intermits associated with patient satisfaction? J Gen Intern Med, 2000,15:122-128
[58]尹文强,王克利,傅华.社区卫生服务职工工作满意度与稳定性研究[J].中华医院管理杂志,2003,19(6)：351-354.
[59]刘朝杰,李伟,姚岚.澳大利亚的社区卫生服务与全科医疗对中国的影响和蕴义[J].中国全科医学杂志,2004 7(21),1545-1550.
[60]陈霞.社区卫生服务模式的思考[J].中国社区医师,2005,18(3)：4-5.
[61]刘毅俊,李滔,朱宏斌等.对武汉市社区卫生服务中心医药分开改革的情况分析与思考[J].中国卫生事业管理,2007, (3)：204-205.
[62]庞连智,祝友元,张鹊,等.全科团队新模式下社区卫生服务中心内部机构设置思路[J].中国全科医学,2006,9(3)：191-192.
[63]鲍勇,严惠杰,沈伟珍.社区卫生服务项目流程化管理研究(一)实施策略[J].中国全科医学,2005,8(3)：182-185.
[64]刘伟,江一民等.社区卫生服务中心流程再造的探索[J].中华医院管理杂志,2005,21 (3):188-189.
[65]叶慰军,水黎明,杜丽君等.项目管理模式在社区卫生服务管理中的应用[J].中国全科医学,2008,11(2)：271-273.
[66]卢祖洵,姚岚,金建强.各国社区卫生服务简介及特点分析[J].中国全科医学,2002,5 (1):38-39.
[67]卢祖洵.中、美两国社区卫生服务比较[J].中国全科医学,2002,5(4)：292-295.
[68]陈子敏,姚岚,舒展等.收支两条线对降低居民就诊费用的效果分析[J].中国全科医学杂志,2007,10(21)：1828-1830.
[69]陈子敏,姚岚,金生国等.收支两条线对社区卫生服务机构内部运行机制的作用分析[J].中国医院管理,2007,27(12)：25-27.
[70]祝友元,张鹭鹭.社区卫生服务机构实施委托经营管理改革的条件探讨[J].解放军医院管理杂志,2005,12(2)：126-127.
[71]PauL A, Lamarche. Marie-dominique beaulieu, raynald pineault. choice for change [R]. The restructuring primary healthcare service in Canada,2004.
[72]Developing Ontario's health system performance management scorecard. Health care:New research, new priorities new directions [R]. January2006.
[73]Primary care for children. Primary care in Ontario[R]. Institute for clinical evaluation science,2004.
[74]杨辉.澳大利亚全科医学服务质量管理框架、措施及借鉴[J].中国全科医学杂志,2006(11),869-872.
[75]杨辉.澳大利亚政府和专业组织在提高全科医学服务质量中的作用及借鉴[J].中国全科医学杂志,2006(11),875-877.
[76]Martinc Misener R, McNab J, Sketris IS, et al. Collaborative practice in health systems change:The Nova Scotia experience with the Strengthening Primary Care Initiative [J]. Can J Nurs Leadership,2004 May; 17(2):33-45.
[77]Diane EW, Anne-marie B, Robert JR. A results-based logic model for primary health care. Laying an evidence -based foundation to guide performance, monitoring and evaluation [R]. College of health disciplines, the university of British Columbia,2004.
[78]李林贵,刘春宏,韩春艳等.国内外社区卫生服务评价研究进展[J].中国卫生经济,2008,27(12),46-48.
[79]任晓晖,李宁秀,高博等.关于建立城市社区卫生服务评价指标体系的思考[J].中国全科医学,2005,8(9),1463-1464.
[80]张忠霖,张建萍,朱学德.SWOT分析法与医院管理理论探讨[J].中国医院,2002,7(5)：15-17.
[81]雷海潮,吴国安,刘金峰,等.加入WTO后我国公立医院发展的SWOT分析[J].中国医院管理,2002,22(2)：1.
[82]杨小东.SWOT理论及实战分析[J].井冈山医专学报,2004,11(6)：121-122.
[83]王秉安,甘健胜.SWOT营销战略分析模型[J].系统工程理论与实践,1995,(12):34-40,45.
[84]马伟光,李继平.21世纪实施临床路径的SWOT分析[J].中国实用护理杂志,2004,20(5)：48-49.
[85]沈旭东,刘晓荣,陈国良等.SWOT分析法在某医院机动卫勤分队培训中的应用分析 [J].解放军护理杂志,2007,24(11)：73-74.
[86]樊立华,户宏艳,李莉等.不同举办形式开展社区卫生服务的SWOT分析[J].中国农村卫生事业管理,2007,27(2)：107-109.
[87]叶真,朱敏洁,郑卫军等.农村公共卫生服务体系建设的SWOT分析[J].中国卫生事业管理,2008,(3)：148-150.
[88]刘彩,王健.我国民营社区卫生服务机构的SWOT分析[J].社区医学杂志,2009,7(1)：64-66.
[89]徐小炮,尹爱田.我国社区卫生服务机构的SWOT分析[J].社区医学杂志,2006,4(8):62-63.
[90]沈枫,李野,严中平.驻店执业药师与医院医师优势合作的SWOT分析[J].中国药房,2004,15(5)：317-318.
[91]陈娜.运用SWOT分析,初探社区药店发展新模式[J].上海医药,2006,27(6)：251-252.
[92]肖达勇.用SWOT分析法探讨疾控工作的机遇与挑战[J].中国公共卫生管理,2008,24(1):12-14.
[93]邱鹏芳,郑振恮.新型农村合作医疗契机下的乡镇卫生院SWOT分析[J].卫生经济研究,2007,(7)：18-19.
[94]张艳丽,冀春亮.新型农村合作医疗的SWOT分析[J].卫生经济研究,2006,(4):32-33.
[95]陈炜锋,许强,方小衡.社区卫生服务SWOT分析[J].现代医院,2007,7(7)：150-152.
[96]姜良美,郭继志,庄立辉.新形势下开展社区健康教育预防慢性病的SWOT分析[J].中国卫生事业管理,2008,(11)：756-768.
[97]FREEMAN R E. Strategic Management:A Stakeholder Approach [M]. Boston: Pitman,1984.
[98]斯蒂芬·P·罗宾斯.管理学[M].第4版.北京：中国人民大学出版社, 2002：101.
[99]冯占春,熊占路.公立医院治理结构变革引入利益相关者理论的必要性分析[J].中国医院管理,2007,27(3)：11-12.
[100]张颖,李永辉.国外全科医生的特点及启迪[J].中华医院管理杂志,2005,21(3):213-214.
[101]姚岚, 陈埙吹,刘运国,等.利用利益相关者理论分析我国农村医疗机构单病种定额付费[J].中国医院管理,2007,27(7)：22-24.
[102]杨善发,黄余送,王永莲,等.新型农村合作医疗政策利益相关者分析[J].中国农村卫生事业管理,2007,27(5)：323-326.
[103]李林贵,杨金侠,林韬,等.新型农村合作医疗不同利益相关者分析及启示[J].卫生经济研究,2007,(6)：44-45.
[104]尹文强,安妮,冯学山,等.社区卫生服务的情景分析[J].中华医院管理杂志,2004,20(3):135-138.
[2]Franks P, Fiscella K. Primary care physicians and specialists as personal physicians. Health care expenditures and mortality Experience. J Fam Pract,1998,47:1052109.
[3]闵维方等.高等教育运行机制研究[M].人民教育出版社,2002,6：66-90.
[4]王玉环,张亮.社区卫生服务运行机制的理论探究[J],中国卫生事业管理,2006,213 (3):189-191.
[5]Orton P, Fry J. UK Health Care:The Facts [M]. Kluwer Academic Publishers, 1995.36.123.
[6]Clark NM. Community/practice/academic partnerships in public health[J]. Am J Prev Med,1999,16(Suppl3):18-19.
[7]O Martin JC. Avant RF, Bowman MA, etal. The Future of Family Medicine: A collaborative Project of the Family Medicine Community[J]. Annals of Family Med,2004,2(Suppl1):S3-S32.
[8]靳清汉,唐长冬,常振华,等.中医投人与卫生筹资关系探讨[J],中医药管理杂志,2009,17 (12):1113-1114.
[9]仇元峰,张鹭鹭,田伟,等.国内外社区卫生服务发展模式比较[J].中国全科医学,2006,9(17)：1398—1400.
[10]姚岚,陈子敏,陈启鸿,等.实现政府购买建立可持续社区卫生服务筹资机制.中华医院管理杂志,2007,21(10)：654-657.
[11]王梅,徐国桓,张路,等.社区卫生服务筹资与补偿机制的探讨[J].中华医院管理杂志.2000,16(7)：409-412
[12]刘朝杰.澳大利亚的卫生体制与卫生政策[J],中国全科医学,2004,7(21)：1545—1548.
[13]Guy Carrin, Maria-Pia Waelkens, Bart Criel. Community-based health insurance in developing countries:a study of its contribution to the performance of health financing systems [J]. Tropical Medicine and International Health.2005 August,10(8):799-811.
[14]卢祖洵,金生国.国外社区卫生服务[M].人民卫生出版社,2001,10：6-10.
[15]Orchard J. Community development and health in Canada [J]. nurs-Scholarsh, 2000,32(2):205-206.
[16]MINISTRY OF HEALTH(1999a). Health Expenditure Trends in New Zealand 1980-1998[R]. Wellington:Government Printer,.
[17]Eggleston K, Li L, Meng Q, et al. Health service delivery in China:A literature review. World Bank Policy Working Paper,2006.3978.
[18]王枫叶.浅谈政府在社区卫生服务筹资中的作用[J].中国社会医学杂志,2007(04)：224-226.
[19]何国忠,罗五金.政府投入方式对社区卫生服务中心完成公共卫生功能的影响分析[J].医学与社会,2006,(03)：54-57.
[20]Laura Cabiedes, Ana Guillen. Adopting and adapting managed competition: health care reform in southern Europe [J]. Social Science & Medicine,2001(52)：1205-1217.
[21]刘昆仑.政府购买公共服务在卫生服务领域的可行性探讨[J].中国卫生经济,2009,28 (1):7-9.
[22]Natasha Palmer. The use of private—sector contracts for primary health care:theory, evidence and lessons for low-income and middle-income countries[J]. Bulletin of the WOrld Health Organization,2000,78(6):821—826.
[23]Alexander S, Preker, April Harding. "Make or Buy" decisions in the production of health care goods and service:new insights from institutional economics and organizational theory[J]. Bulletin of the World Health Organization,2000,78(6):779-788.
[24]William Jack. Optimal risk adjustment with adverse selection and spatial competition[J]. Journal of Health Economics,2005, (25):908-926.
[25]Cutler D. Equality, Efficiency, Market. Fundamentals:The dynamics of international medical care[J]. Journal of Economics Literature,2002, 40 (3):881-906.
[26]Castledine G. Can performance- related pay be adapted for nursing? British Journal of Nursing 1993,2(22):1120-1121.
[27]Buchan J. and Thompson M.. Pay and nursing performance. Health Manpower Management 1993,19(2):29-31.
[28]Chapin J, Fetter B Performance- based contracting in Wisconsin public health:transforming state- local relations. Milbank Q.2002,80(1):97-124.
[29]孟庆跃.医疗保险支付方式改革对费用控制的影响分析.卫生经济研究,2002,(9):18-21.
[30]傅家康.社区卫生服务机构收支两条线改革的实践及思考[J].卫生经济研究,2007, (2):51-52.
[31]1 White, Peter, William. Rural Workforce Agencies Minimum Data Set Report as at 30 November 2004:7.
[32]Ulmer B, Harris M'Australian GP are satisfied with their job:even more so in rural areas. Fam Pract,2002,19(3):300-3.
[33]Anell A. Persson M. Intemational comparisons ofhealth care resouTces. L akartidningen,1998,95(30-31):3315-8.
[34]Y. Zhao, S. Cui, J. Yang, etal. Basic public health services delivered in an urban community:a qualitative study[J]. public health.2010,125(2011)37-45.
[35]Pei L, Stanton P, Legge D Improving human resource management in Chinese heath care:identifying the obstacles to change, Australian Health Review, 2004,27:124-130.
[36]姚岚,龚勋,熊巨洋等.社区卫生服务中心个人绩效考核方案初探[J].中国卫生经济,2006,26(12)：13-15.
[37]李芳.我国人事制度改革的哲学反思[J].理论探讨.2001(3)：33—34.
[38]尤川梅,姚岚,王芳,等.“定编、定岗、不定人”收支两条线管理下社区卫生服务机构的人事制度设计[J],中国卫生经济,2010(323)：70-73.
[39]Pei L. Legge D, Stanton P Policy contradiction limiting hospital performance. Policy Studies,2000,21:99-114.
[40]Huey-Ming Tzeng, Shake Ketefian, Richand w. Redman. Relationship of nurses assessment of organizational culture, job satisfaction and patient satisfaction with nursing care. International journal of nursing studies, 2003,39:79-84
[41]Haas JS, Cook EF, Puopolo RL, etc. Is the professional satisfaction of general intermits associated with patient satisfaction? J Gen Intern Med,2000,15：122-128
[42]刘朝杰,李伟,姚岚.澳大利亚的社区卫生服务与全科医疗对中国的影响和蕴义[J].中国全科医学杂志,2004 7(21),1545-1550.
[43]陈霞.社区卫生服务模式的思考[J].中国社区医师,2005,18(3)：4-5.
[44]Gomez-Mejia L R. Structure and process of diversification compensation strategy and firm performance [J]. Strategic Management Journal,1992 (10):21-25.
[45]Robbins S P. Personnel:The Management of Human Resources [R].2004.
[46]李华任,荣伟.360度绩效评估法的运用及有效性分析[J].现代管理科学,2004,8:33-34.
[47]Virginia Department of Planning and Budget. Virginia's Handbook on Planning and Performance [M]. Virginia Department of Planning and Budget,1998.
[48]刘运国、张亮.初级卫生保健机构绩效评价[M].北京：中国财政经济出版社,2007.
[49]PauL A, Lamarche. Marie-dominique beaulieu, raynald pineault. choice for change [R]. The restructuring primary healthcare service in Canada,2004.
[50]Developing Ontario's health system performance management scorecard. Health care:New research, new priorities new directions [R]. January2006.
[51]Primary care for children. Primary care in Ontario[R]. Institute for clinical evaluation science,2004.
[52]Martinc Misener R, McNab J, Sketris IS, et al. Collaborative practice in health systems change:The Nova Scotia experience with the Strengthening Primary Care Initiative[J]. Can J Nurs Leadership,2004 May; 17(2):33-45.
[53]Diane EW, Anne-marie B, Robert JR. A results-based logic model for primary health care. Laying an evidence -based foundation to guide performance, monitoring and evaluation [R]. College of health disciplines, the university of British Columbia, 2004.
[54]樊延军,刘朝杰.澳大利亚社区卫生服务系统评审项目对我国社区卫生服务的借鉴价值[J].中国全科医学,2007,10(20)：1704-1705.
[55]刘运国,张亮,等.初级卫生保健机构绩效评价[M].北京：中国财政经济出版社, 2007.
[56]庄霞,尹爱田,任绪功,等.构建综合医院绩效评价关键指标体系的研究[J].中华医院管理杂志,2006,5(6)：341-344.
[57]Milton I. Roemer, Ruth J. Roemer. Health Care Systems and Comparative Manpower Policies, Leichter Journal of Health Politics, Policy and Law.1982,7:532-534.
[58]王芳,张全红,金建强等,社区卫生服务绩效评价指标体系的信度与效度评价[J].中国全科医学,2008,1A(11)：77-79.
[59]Church A H, Bracken D W. Advancing the State of the Art of 360 Degree Feedback[J]. Group & Organization Management,1997,22 (2):149-161.
[60]NICE clinical guideline.hypertention:Management of hypertension in adults in primary care[R]. National institute for health and clinical excellence,2004.
[61]刘毅俊,李滔,朱宏斌等.对武汉市社区卫生服务中心医药分开改革的情况分析与思考[J].中国卫生事业管理,2007, (3)：204-205.
[62]王铮,陈瑶,王峥等.社区卫生服务机构零差率药品断货现象分析[J].中国卫生经济,2008,27(7)：22-24.
[63]陈铮,高军.社区药品“零差率”任重道远——冷观社区卫生服务药品集中采购和集中配送[J].首都医药,2007(3)：15-19.
[64]张忠霖,张建萍,朱学德.SWOT分析法与医院管理理论探讨[J].中国医院,2002,7(5)：15-17.
[65]雷海潮,吴国安,刘金峰,等.加入WTO后我国公立医院发展的SWOT分析[J].中国医院管理,2002,22(2)：1
[66]樊立华,户宏艳,李莉等.不同举办形式开展社区卫生服务的SWOT分析[J]中国农村卫生事业管理,2007,27(2)：107-109.
[67]Leibenstein H. The theory of underemployment in densely populared backward areas, in Harvey leibenstein, (ed), economic backwardness and economic growth[M]. New York:John Wiley & Sons,1963.
[68]Lardy N. Economic growth and distribution in China. New York:Cambridge University Press.1999,50.
[69]Pei L. Hospital management in a time of change:the need for management training (and policy reform) in three teaching hospitals in Yunnan. UMI: A Bell & Howell Company, Ann Arvor, Michigan,1998.30-32
[70]Duckett SJ. The Australian health care system (2nd edition), Oxford University Press, Oxford,59.
[71]Helen P. Bartlett. Community health policy and provision in Hong Kong: challenges for 1997 and beyond. Health & Place, Vol.1, No.4, pp.243-249, 1995.
[72]Fine MD. Coordinating health, extended care, and community support services:reforming aged care in Australia. Journal ofAging&Social Policy,1999.11(1):67-90.
[1]Hall J J, Taylor R. Health for all beyond 2000:the demise of the AL -ma Ata Declaration and primary health care in developing countries [J]. MJA,2003,178 (1):17-20.
[2]马鸣,尤川梅,姚岚.促进大型企业医院转型社区卫生服务的发展[J].中国卫生经济,2006,26(11)：51-53.
[3]王枫叶.政府主导下的社区卫生服务市场化管理模式[J].中国初级卫生保健,2008,22(4)：23-25.
[4]刘毅俊,李滔,邹吉更等.加大社区卫生服务经费投入推进其可持续发展[J].中国卫生经济,2007,26(9)：34.
[5]韩方群.中澳社区卫生服务的比较及启示[J].1中国全科医学,2005,8：1506.
[6]陈渊青,罗乐宣,王跃平,等1国内外社区卫生服务的进展[J].中国全科医学,2004,7:1098.
[7]仇元峰,张鹭鹭,田伟等.国内外社区卫生服务发展模式比较[J].中国全科医学,2006,9(17)：1397-1398.
[8]张莹,苏珍玲,周彬,等.中澳社区卫生服务比较与启迪[J].现代预防医学,2003,30 (4):589-592.
[9]张愈.开展区域卫生规划进行卫生资源调整积极探索社区卫生服务发展新思路[J].中华医院管理杂志,2005,21(5)：289-292.
[10]庞连智,祝友元,贺金仙,等.上海城市社区卫生服务中心资产委托经营管理改革研究[J]. 解放军医院管理杂志,2004,11(5)：446-447.
[11]葛敏,江萍,赵晓明.社区卫生服务发展中的政府主导作用[J].中国卫生经济,2007,26 (9):29-31.
[12]王光荣,詹绍康,郭怀保等.上海市闸北区社区卫生服务管理体制改革研究概述[J].中华医院管理杂志,2005,21(8)：509-513.
[13]任涛,胡永华.对当前社区卫生服务中面临问题的几点思考[J].中国公共卫生管理,2007,23(6)：567-568.
[14]迟玉聚,姚岚,张丽芳.民营社区卫生服务发展的优势与挑战[J].中国卫生经济,2007,26(12)：10-12.
[15]尤川梅, 舒展, 易春黎等.企事业医疗机构转型社区卫生服务的居民满意度调查[J].中国卫生经济,2008,27(1)：51-54.
[16]骆亮,陈颖姣.双向转诊制度实施问题研究[J].卫生经济研究,2006,(11)：46-47
[17]卢杨,张鹭鹭,马玉琴,等.医院与社区卫生服务互动的影响因素分析与对策研究[J].中国全科医学杂志,20091 2(2A),206-207.
[18]卢祖洵,刘军安,彭绩等.深圳市社区卫生服务利用及其影响因素分析[J].中华医院管理杂志,2005,21(7)：464-467
[19]陈子敏,王光荣,陈启鸿等.实现政府购买建立可持续性社区卫生服务筹资机制[J].中华医院管理杂志,2005,21(10)：654-657.
[20]邹宗峰,邹宇华,张瑛等.城市社区公共卫生服务优先项目的筛选方法和补偿机制研究[J].中国卫生经济,2009,28(1)：58-60.
[21]徐林山,程晓明,周召梅等.城市社区公共卫生服务项目分类研究[J].中华医院管理杂志,2005,21(2)：86-88.
[22]尹爱田,俞水,杨百团,等.基层卫生机构功能定位和财政投入机制[J].中国卫生经济,2007,26(12)：86-88.
[23]朱骥,王光荣,李哲等.社区卫生服务授权经营改革对服务提供的影响[J].中华医院管理杂志,2005,21(8)：513-515.
[24]沈慰如.对政府购买社区公共卫生产品的设想[J].卫生经济研究,2004,(9)：15-16.
[25]何国忠,罗五金,姚岚等.政府投入方式对社区卫生服务中心完成公共卫生功能的影响分析[J].医学与社会,2006,19(3)：54-56.
[26]张媚,景琳,李玉强等.从成本测算结果探讨政府购买模式下的社区公共卫生服务财政补偿[J].中国卫生经济,2009,28(1)：46-48.
[27]江萍.对政府购买社区公共卫生服务的探索[J].上海预防医学杂志,2002,14(5)：243.
[28]徐林山,程晓明,朱坤等.四城市社区公共卫生服务项目成本测算[J].中国卫生经济,2005,24(7)：37-39.
[29]姚岚,陈启鸿,林玲等.实现社区卫生服务机构内部市场化运作[J].中华医院管理杂志,2005,21(10)：657-659.
[30]张成勉, 孙永发, 吴华章.我国社区卫生服务中政府购买公共卫生服务项目的难点和建议[J].中国卫生经济,2009,28(1)：44-45.
[31]Laura Cabiedes, Ana Guillen. Adopting and adapting managed competition: health care reform in southern Europe [J]. Social Science & Medicine,2001 (52):1205-1217.
[32]刘昆仑.政府购买公共服务在卫生服务领域的可行性探讨[J].中国卫生经济,2009,28(1)：7-9.
[33]William Jack. Optimal risk adjustment with adverse selection and spatial competition[J]. Journal of Health Economics,2005, (25):908-926.
[34]Cutler D. Equality, Efficiency, Market. Fundamentals:The dynamics of international medical care[J]. Journal of Economics Literature,2002, 40 (3):881-906.
[35]郑红,郭亚军, 曾华.基于期权理念的国家基本医疗卫生服务管理模式研究[J].中国卫生经济,2009,28(3)：5-7.
[36]傅鸿鹏,何倩,俞金枝等.看病难看病贵研究的文献评价[J].中华医院管理杂志,2006,22(10)：701-704.
[37]Buchan J. Performance- related pay and NHS nursing. Nurs. Stand.1993, 7(25):30.
[38]Castledine G. Can performance- related pay be adapted for nursing? British Journal of Nursing 1993,2(22):1120-1121.
[39]Buchan J. and Thompson M.. Pay and nursing performance. Health Manpower Management 1993,19(2):29-31.
[40]Chapin J, Fetter B Performance-based contracting in Wisconsin public health:transforming state-local relations. Milbank Q.2002,80(1):97-124.
[41]Kouides RW et al. A performance-based incentive program for influenza immunization in the elderly. Am J Prev Med.1993 Jul-Aug 9(4):250-255.
[42]Kouides RW et al. Performance-based physician reimbursement and influenza immunization rates in the elderly. The Primary-Care Physicians of Monroe County. Am J Prev Med 1998 Feb 14 (2):89-95.
[43]Leese B and Bosanquet N Changes in general practice organization:survey of general practitioners' views on the 1990 contract and fundholding. Br J Gen Pract.1996,46 (403):95-99.
[44]孟庆跃.医疗保险支付方式改革对费用控制的影响分析.卫生经济研究,2002,(9)：18-21.
[45]宫习飞,于保荣,袁蓓蓓,等.基层卫生服务机构支付方式研究[J].中华医院管理杂志,2007,26(9)：54-56.
[46]陈娜,冯国忠.单病种限价的SWOT分析及对策研究[J].西部药学,2007,4(3)：144-146.
[47]洪哲芳,程晓明,赵大海等.山西省和顺县“合同购买卫生服务”项目评价[J].中国卫生经济,2008,27(3)：45-46.
[48]王万荣,何晓琦,陈叶纪.合同购买重点卫生服务试点研究[J].中华医院管理杂志,2006 22(12),799-802.
[49]马亚娜,翁开源,宋雪佳等.不同城市社区卫生服务人力资源的比较研究[J]. 中国卫生事业管理,2004,(5)：286-288.
[50]张泽,祁素文.国外社区卫生服务现况及启示[J].中国全科医学杂志,20058(16),1283-1284.
[51]张跷玲,李红玉.澳大利亚的社区卫生服务模式对中国全科医学教育的启示[J].中国卫生事业管理,2004,(2)：99-101.
[52]傅家康.社区卫生服务机构收支两条线改革的实践及思考[J].卫生经济研究,2007, (2):51-52.
[53]李再强,林枫.国外社区首诊制度简介[J].中国卫生经济,2006,25(2):76-77.
[54]NICE clinical guideline. hypertention:Management of hypertension in adults in primary care[R]. National institute for health and clinical excellence,2004.
[55]姚岚,龚勋,熊巨洋等.社区卫生服务中心个人绩效考核方案初探[J].中国卫生经济,2006,26(12)：13-15.
[56]Huey-Ming Tzeng, Shake Ketefian, Richand w. Redman. Relationship of nurses assessment of organizational culture, job satisfaction and patient satisfaction with nursing care. International journal of nursing studies,2003,39：79-84
[57]Haas JS, Cook EF, Puopolo RL, etc. Is the professional satisfaction of general intermits associated with patient satisfaction? J Gen Intern Med, 2000,15:122-128
[58]尹文强,王克利,傅华.社区卫生服务职工工作满意度与稳定性研究[J].中华医院管理杂志,2003,19(6)：351-354.
[59]刘朝杰,李伟,姚岚.澳大利亚的社区卫生服务与全科医疗对中国的影响和蕴义[J].中国全科医学杂志,2004 7(21),1545-1550.
[60]陈霞.社区卫生服务模式的思考[J].中国社区医师,2005,18(3)：4-5.
[61]刘毅俊,李滔,朱宏斌等.对武汉市社区卫生服务中心医药分开改革的情况分析与思考[J].中国卫生事业管理,2007, (3)：204-205.
[62]庞连智,祝友元,张鹊,等.全科团队新模式下社区卫生服务中心内部机构设置思路[J].中国全科医学,2006,9(3)：191-192.
[63]鲍勇,严惠杰,沈伟珍.社区卫生服务项目流程化管理研究(一)实施策略[J].中国全科医学,2005,8(3)：182-185.
[64]刘伟,江一民等.社区卫生服务中心流程再造的探索[J].中华医院管理杂志,2005,21 (3):188-189.
[65]叶慰军,水黎明,杜丽君等.项目管理模式在社区卫生服务管理中的应用[J].中国全科医学,2008,11(2)：271-273.
[66]卢祖洵,姚岚,金建强.各国社区卫生服务简介及特点分析[J].中国全科医学,2002,5 (1):38-39.
[67]卢祖洵.中、美两国社区卫生服务比较[J].中国全科医学,2002,5(4)：292-295.
[68]陈子敏,姚岚,舒展等.收支两条线对降低居民就诊费用的效果分析[J].中国全科医学杂志,2007,10(21)：1828-1830.
[69]陈子敏,姚岚,金生国等.收支两条线对社区卫生服务机构内部运行机制的作用分析[J].中国医院管理,2007,27(12)：25-27.
[70]祝友元,张鹭鹭.社区卫生服务机构实施委托经营管理改革的条件探讨[J].解放军医院管理杂志,2005,12(2)：126-127.
[71]PauL A, Lamarche. Marie-dominique beaulieu, raynald pineault. choice for change [R]. The restructuring primary healthcare service in Canada,2004.
[72]Developing Ontario's health system performance management scorecard. Health care:New research, new priorities new directions [R]. January2006.
[73]Primary care for children. Primary care in Ontario[R]. Institute for clinical evaluation science,2004.
[74]杨辉.澳大利亚全科医学服务质量管理框架、措施及借鉴[J].中国全科医学杂志,2006(11),869-872.
[75]杨辉.澳大利亚政府和专业组织在提高全科医学服务质量中的作用及借鉴[J].中国全科医学杂志,2006(11),875-877.
[76]Martinc Misener R, McNab J, Sketris IS, et al. Collaborative practice in health systems change:The Nova Scotia experience with the Strengthening Primary Care Initiative [J]. Can J Nurs Leadership,2004 May; 17(2):33-45.
[77]Diane EW, Anne-marie B, Robert JR. A results-based logic model for primary health care. Laying an evidence -based foundation to guide performance, monitoring and evaluation [R]. College of health disciplines, the university of British Columbia,2004.
[78]李林贵,刘春宏,韩春艳等.国内外社区卫生服务评价研究进展[J].中国卫生经济,2008,27(12),46-48.
[79]任晓晖,李宁秀,高博等.关于建立城市社区卫生服务评价指标体系的思考[J].中国全科医学,2005,8(9),1463-1464.
[80]张忠霖,张建萍,朱学德.SWOT分析法与医院管理理论探讨[J].中国医院,2002,7(5)：15-17.
[81]雷海潮,吴国安,刘金峰,等.加入WTO后我国公立医院发展的SWOT分析[J].中国医院管理,2002,22(2)：1.
[82]杨小东.SWOT理论及实战分析[J].井冈山医专学报,2004,11(6)：121-122.
[83]王秉安,甘健胜.SWOT营销战略分析模型[J].系统工程理论与实践,1995,(12):34-40,45.
[84]马伟光,李继平.21世纪实施临床路径的SWOT分析[J].中国实用护理杂志,2004,20(5)：48-49.
[85]沈旭东,刘晓荣,陈国良等.SWOT分析法在某医院机动卫勤分队培训中的应用分析 [J].解放军护理杂志,2007,24(11)：73-74.
[86]樊立华,户宏艳,李莉等.不同举办形式开展社区卫生服务的SWOT分析[J].中国农村卫生事业管理,2007,27(2)：107-109.
[87]叶真,朱敏洁,郑卫军等.农村公共卫生服务体系建设的SWOT分析[J].中国卫生事业管理,2008,(3)：148-150.
[88]刘彩,王健.我国民营社区卫生服务机构的SWOT分析[J].社区医学杂志,2009,7(1)：64-66.
[89]徐小炮,尹爱田.我国社区卫生服务机构的SWOT分析[J].社区医学杂志,2006,4(8):62-63.
[90]沈枫,李野,严中平.驻店执业药师与医院医师优势合作的SWOT分析[J].中国药房,2004,15(5)：317-318.
[91]陈娜.运用SWOT分析,初探社区药店发展新模式[J].上海医药,2006,27(6)：251-252.
[92]肖达勇.用SWOT分析法探讨疾控工作的机遇与挑战[J].中国公共卫生管理,2008,24(1):12-14.
[93]邱鹏芳,郑振恮.新型农村合作医疗契机下的乡镇卫生院SWOT分析[J].卫生经济研究,2007,(7)：18-19.
[94]张艳丽,冀春亮.新型农村合作医疗的SWOT分析[J].卫生经济研究,2006,(4):32-33.
[95]陈炜锋,许强,方小衡.社区卫生服务SWOT分析[J].现代医院,2007,7(7)：150-152.
[96]姜良美,郭继志,庄立辉.新形势下开展社区健康教育预防慢性病的SWOT分析[J].中国卫生事业管理,2008,(11)：756-768.
[97]FREEMAN R E. Strategic Management:A Stakeholder Approach [M]. Boston: Pitman,1984.
[98]斯蒂芬·P·罗宾斯.管理学[M].第4版.北京：中国人民大学出版社, 2002：101.
[99]冯占春,熊占路.公立医院治理结构变革引入利益相关者理论的必要性分析[J].中国医院管理,2007,27(3)：11-12.
[100]张颖,李永辉.国外全科医生的特点及启迪[J].中华医院管理杂志,2005,21(3):213-214.
[101]姚岚, 陈埙吹,刘运国,等.利用利益相关者理论分析我国农村医疗机构单病种定额付费[J].中国医院管理,2007,27(7)：22-24.
[102]杨善发,黄余送,王永莲,等.新型农村合作医疗政策利益相关者分析[J].中国农村卫生事业管理,2007,27(5)：323-326.
[103]李林贵,杨金侠,林韬,等.新型农村合作医疗不同利益相关者分析及启示[J].卫生经济研究,2007,(6)：44-45.
[104]尹文强,安妮,冯学山,等.社区卫生服务的情景分析[J].中华医院管理杂志,2004,20(3):135-138.