In view of such outcomes of the performance pay practice at primary healthcare institutions as decline of motivation of medical workers,the county explored the mechanism of graded performance appraisal and allocation,against the macro background of ceiling setting for the total of performance pay andbalance subsidy and total amount controlfiscal policy.The following measures are taken,namely a dual linkage to relate the performance appraisal outcome of a township hospital with both allocation of fiscal subsidy and setting of the merit-based performance pay standard per person;higher ratio of merit-based performance pay;floating of the performance pay level per person for the institution in question;separation of the performance pay of the chief leader from others;and subsidies for remote mountainous areas.It is proposed by the author to build a routine increase mechanism for both the total of performance pay and fiscal subsidies,to combine specific subsidy with pay for services,and to join funding compensation with service performance.These measures are expected to create a new mechanism for performance pay allocation,featuring more pay for more work and more pay for better performance.

Introduced and analyzed in the paper are a reform made in Suichang county of Zhejiang province,in which a general community health center is established as an affiliate to the county TCM hospital which oversees the medical personnel,financial and properties of primary health centers in the country.An analysis of the merits and setbacks of the practice,the authors hold that the reform to build vertical medical consortiums between county-level public hospitals and primary health centers should emphasize the principles of “Consolidating the primary level and benefiting the people”,keep the rights and obligations consistent,and emphasize functional integration and resources sharing in terms of patient flow,personnel,facilities,technology,information and management.