我国农村订单定向医学生免费培养政策的多重制度逻辑分析OA

The implementation of free training of rural order-oriented medical students is a significant measure to deepen healthcare reform and strengthen the construction of general practitioner team,and it is also a radical measure to improve the overall quality of the rural grass-roots health team and promote the establishment of a hierarchical diagnosis and treatment system.Based on the analysis of the free training policy for rural order-ori-ented medical students in China by using the theory of multiple institutional logic,it is found that various subjects cooperate and interact around the common goals in the organizational field,forming multiple system logic represen-tation of top-level design by the central government(decision-making logic),implementation of policies by local government(implementation logic),personnel training in medical colleges and universities(education logic),targeted employment of township health centers(use logic),and career choice of oriented medical students(de-velopment logic).When various kinds of institutional logic coexist,the mutual game among institutional logic af-fects the behavior of individuals and organizations,thus resulting in multiple institutional logic order conflicts,such as the separation of implementation between top-level design and policy implementation,the collaborative al-ienation between talent training and oriented employment,the occupation conflict between working in primary healthcare institutions and escape from serving the countryside,and so on.In order to achieve the logical conver-gence of multiple systems,it is necessary to optimize the top-level design,improve the implementation mecha-nism,promote collaborative education and guide the return of talents.