医疗体制改革因其复杂性成为困扰每一个国家的难题，中国的医改也在探索的道路上不断朝着纵深方向推进。尤其是在农村地区，由于长期受到城乡区域发展不均衡的影响，加之原有的医疗基础薄弱，导致人数众多的农村地区医疗服务供给存在较大缺口。农村长期以来形成了一套基于乡土社会且具有市场供给特征的“市场—社会”供给机制，但却因资源薄弱、规模较小不能满足民众的医疗需求。政府试图采用“行政化”的管控手段解决上述问题，但并未得到根本上的解决反而凸显更多问题。目前农村基本医疗服务供给机制的解决对策在“政府”与“市场”之间摇摆不定，政府并未寻找到一条较为有效的问题解决路径。 本研究采用案例分析的质性研究方法，通过呈现“一体化管理”政策落实形成的“市场—社会”和“行政管控”两种农村基本医疗服务供给模式案例，研究目前农村基本医疗服务供给模式的做法和效果差异，并分析存在差异的机制原因。 研究结论有以下几点：第一，“市场—社会”模式和“行政管控”模式做法上的差异在于，第一种模式政府在原有模式基础上叠加自己的资源优势，并在宏观上调控和补足；第二种模式政府将原有模式推翻与替代，进入到自上而下的行政化运作体系中。效果差异在于，第一种模式的效果达到了“政府—市场—社会”三者的优势叠加，第二种模式的效果将政府和市场的弊端叠加放大。第二，供给机制的差异是造成两种模式在做法和效果上呈现明显不同的主要原因。第一种模式的供给机制主要是市场竞争机制和社会监督机制，第二种模式的供给机制是行政管控机制。农村基本医疗服务供给机制有自身的发展脉络，即沿着“市场—社会”脉络提供服务，具有乡土社会和市场活力的双重优势。政府不应将其全盘否定进入到具有“官僚政府”特征的行政化供给机制中，而应在保留原有优势的基础上对其不足进行补充。

Because of its complexity, the reform of the medical system has become a difficult problem for every country, and China's health reform has been constantly moving in a deep direction on the road of exploration. Especially in rural areas, due to the long-term impact of uneven development between urban and rural areas, coupled with the original medical base is weak, resulting in a large number of rural areas of the supply of medical services there is a large gap. The countryside has long formed a set of "market-society" supply mechanism based on local society and has the characteristics of market supply, but it can not meet the medical needs of the people because of its weak resources and small scale. The government has tried to solve the above problems by means of "administrative" control, but it has not been fundamentally resolved but has highlighted more problems. Solutions to the current supply mechanism of rural basic medical services in the "government" and "market" between the wobble, the government has not found a more effective way to solve the problem. This study uses the qualitative research method of case analysis, through presenting the "market-society" and "administrative control" two kinds of rural basic medical Service supply model cases formed by the "Integrated management" policy, this paper studies the current practice and effect difference of the rural basic Medical Service supply model, and analyzes the mechanism reasons for the differences. The conclusions of the study are as follows: first, the difference between the "market-society" model and the "administrative control" mode is that the first mode of government overlays its own resource advantages on the basis of the original model, and regulates and complements them macroscopically; the second model the government overturns and replaces the original model and enters the top-down administrative operation system. The difference in effect is that the effect of the first model has reached the superposition of the advantages of "government-market-society", and the effect of the second model magnifies the drawbacks of government and market. Secondly, the difference of supply mechanism is the main reason that the two models show obvious difference in practice and effect. The supply mechanism of the first model is mainly market competition mechanism and social supervision mechanism, and the second mode of supply mechanism is administrative control mechanism. The supply mechanism of basic medical services in rural areas has its own development context, that is, it provides services along the "market-society" context, with the dual advantages of local society and market vitality. The Government should not put its total negation into the administrative supply mechanism with the characteristics of "bureaucratic government", but should supplement its insufficiency on the basis of retaining the original advantages.