【作者】 苌凤水；

【导师】 郝模； 罗力； 吕军；

【作者基本信息】 复旦大学 ， 社会医学与卫生事业管理， 2006， 博士

【摘要】 一、立题依据和研究目的政策的重要性无可置疑，政策优劣决定事业兴衰，一套可用于指导实践的政策学理论则是促进政策制定科学化的重要前提，而政策制定科学化又可促进政策理论的不断发展，二者之间可形成良性互动关系。西方政策学理论于上世纪40年代作为一门相对独立的学科出现并得以迅速发展，而在70年代末期方开始传入我国，当前在总体上仍处于“引进”阶段，尚未完成学科的“本地化”过程，仍然缺乏符合国情的政策方法论研究。这种情况直接导致了制约我国政策价值提高的“瓶颈”，具体体现在如下五个方面：制定理论要求和现实操作之间差距、政策研究理论要求和实际研究之间差距，又间接引起了政策研究者和决策者隔阂、科研和政策之间差距、政策学与其它学科隔阂。确定政策去向(即评价结果总结反馈)作为政策制定的一个必要环节，其地位已得到国内外政策科学学者的公认，其相关的程序、方法无疑是重要的。然而与政策学理论的研究状况相同，国内对于确定政策去向理论的研究同样表现出了上述五项隔阂，难以有效发挥对确定政策去向实践的指导作用。总课题《公共政策制定和研究方法论》，立足国内，旨在研制政策研究和政策制定优势互补、互为支撑的政策制定科学程式，围绕共同的目标——如何制定高价值政策，为政策制定者和研究者提供一整套政策制定和政策研究的步骤和程序。围绕提供政策制定和政策研究的步骤和程序目的，总课题研究将拟解决的理论和实践中存在的问题归纳为九个子课题，子课题间有机联系共同构成“政策制定科学程序”，本研究在总课题研究中的定位如图1。总课题研究属理论完善型研究，得到了国家杰出青年基金(79925002)的资助。本研究将在总课题的基本框架下，围绕“确定政策去向”环节展开探索。本部分研究的目的在于，在弥补国内现有著作中确定政策去向理论的不足基础上，旨在为国内研究者和决策者提供一套研究和决策互为支撑的确定政策去向程式，包括框架思路、步骤、各步骤的定义、目的、基本思路和原则、常用方法推荐，以及各步骤中需注意的主要问题、研究者和决策者各自优势与职责。研究包括理论探索和实证模拟两个部分。理论探索部分，重在明确国内政策学中确定政策去向理论的不足和缺陷，在弥补不足和缺陷的基础上，推荐研究和决策互为支撑的确定政策去向操作程式。实证模拟部分则重在运用现实数据，模拟和验证所推荐的确定政策去向操作程式。二、材料与方法(一)理论探索部分本学科(政策科学)之所以存在着制约政策价值的瓶颈和相应的五大隔阂，可追源于“逻辑性、科学性、可操作性和合理性”方面表现出种种的不足。作为课题组一员，参与构建了“逻辑性、科学性、可操作性和合理性”评价指标体系，作为对包括确定政策去向理论在内的政策科学理论进行评价与完善的基本标准。该指标体系共包括42个具体指标，以这些指标及其标准为框架，运用规范-差距分析法这一指导性研究方法展开理论完善研究。在分析确定政策去向环节的不足、缺陷和空白阶段，通过比较国内政策学著作的“逻辑性、科学性、可操作性和合理性”现状与“理想”状况，以判断其间的差距，确定存在的不足、缺陷或空白。在缺陷明确的基础上，针对差距分别予以完善或弥补，并构建确定政策去向程式的基本框架、思路和步骤，再次运用评价指标体系中的各指标作为工具，对确定政策去向程式的整体和各个步骤分别予以充实完善。运用专家咨询法，对本研究缺陷分析进行认同度判断，以及对完善后所形成的确定政策去向理论完善程度加以评价。理论探索部分的资料系采用普查方法收集截止2004年年底国内所有政策学著作，共计40部。(二)实证模拟部分依据本研究所推荐的“确定政策去向程式”，对“1993年卫生事业单位的工资制度”的归宿展开模拟论证研究，判明该制度的去向。该项研究将以我国公立医疗机构工资分配制度的现状为基础展开讨论。主要的资料收集方法包括专题调查、常规统计资料提取和意向调查等。实证模拟中应用的具体方法包括各种统计描述和检验方法，如平均数、二独立样本的非参数检验；归纳的方法；多因素分析法，包括多元线性回归、主成分回归等；文献复习法等。三、主要研究结果(一)完善确定政策去向程式的理论探索1．确定政策去向环节理论的现况和不足按照“逻辑性、科学性、可操作性和合理性”指标体系的顺序，从确定政策去向总体到信息反馈、政策调整、政策法律化和政策终结四个步骤，针对现有国内政策学著作相关的内容逐一评价分析。分析结果明确了现有著作中确定政策去向环节的理论现状，确认了其中存在的一系列潜在的不足、缺陷和待完善之处。并且在缺陷分析的基础上，定量明确了现有著作中确定政策去向环节内容的待完善程度。(1)确定政策去向核心目的和实现目的思路、步骤、原则与方法等方面的不足规范表达有关“政策去向”是政策学理论体现系统性、避免随意性的一个重要和基本前提，但恰恰现有政策学领域中解释“政策去向”的各种概念存在缺乏规范的现象。这无疑构成了整个政策去向环节的一个基本缺陷。确定政策去向核心目的表述方面，过半数(57.5％)专著未提及关于确定政策去向这一政策环节的核心目的，目的阐述的明确程度平均为2.2分，待完善程度为55.6％。现有著作中，关于本环节目的的最准确论述出现在政策监督和信息反馈相关内容中，“其目的在于及时掌握政策执行中的偏差现象，检查督导政策执行过程，及时掌握政策发生效果的信息资料，以决定是继续执行现有政策，还是需要修正或追踪决策”。这个论述与“确定政策去向”的关系非常密切，但尚不准确也不够明确，仅提示了“政策继续”和“政策调整”两个去向。所以关于本环节的核心目的，需要在系统明确概念的基础上加以明确表述。另外，缺乏较为系统规范的政策去向判断指标，更缺乏完善的政策去向判断标准。至于可以认为是与标准有关的内容，政策调整包括政策调整有关的导致因素、影响因素、前提依据、原因等等内容，政策终结包括定义、依据、形式、类型、原因或导致终结的情况等等内容，有关政策法律化的标准见于政策法律化定义以及政策法律化条件中，内容总体上分布均较为分散，详略、表述差异也较大。对考核指标以9分制评价，得分范围在1-4分之间，平均分为2.2分，待完善程度为55.6％。确定政策去向思路原理方面，在存在前述缺陷的基础上，再加上存在政策评价环节与本环节之间的联系不清的现象，这就势必造成现有政策学理论对于思路原理不可能进行有较系统的认识和阐述。现有理论虽然认识到信息反馈与实现核心目的之间有密切的联系，但相关内容对实现核心目的的思路原理无明确论述。由于缺乏思路原理的指导，使得现有专著在推荐步骤的逻辑性方面同时缺乏外部逻辑性与内部逻辑性，难以有效指导达成本环节的核心目的。在现有著作中提到的一些原则理论没有很强的针对性，在核心目的不明确的情况下，这些原则与核心目的的关系有待阐述；存在的另外一个问题就是论述普遍简略，落实的思路不明。研究发现一半以上的著作中有或零散或集中论述的方法学内容。进一步分析，发现所有的方法针对性均不清；而3部著作中提到的和本环节总体有关的政策控制方法也存在如下问题：一是现有方法与核心目的的关系不清楚，严重缺乏针对性；二是所介绍的方法内容往往简略，操作要点缺乏，需要进一步参考其他书籍的时候，参考的方向也不是很清楚。可见总体上，本环节核心目的相关理论存在众多不足，不论是研究者还是决策者都无法依据现有理论明确抓住本环节的核心目的，更难以依据现有理论达成本环节的核心目的。(2)确定政策去向与政策制定过程的内在联系经过广泛搜寻发现有52.5％的著作提及有关“确定政策去向”和制定政策核心目的之间关系的论述，但相关论述集中在意义、重要性以及作用等方面，缺乏对于“确定政策去向”与制定政策核心目的关系的明确系统的表述。以9分制判断，提及的理论的平均得分为2.6分，得分范围为1-5分，待完善程度为44.4％。现有理论在论述政策调整和政策终结的意义或者作用中提到“政策调整有利于政策的科学完善，政策调整有利于政策的相对稳定，政策终止有利于节省政策资源，政策终止有利于促进政策优化，政策终止有利于提高政策绩效”等等，但并没有真正道出本环节与“制定高价值政策”乃至解决政策问题的关系，呈现零散、随意的状态。这样也就意味着本环节的有关理论对于制定高价值政策的贡献难以明确，更难以明确与解决政策问题的关系，本环节定位必然会出现模糊的现象，其价值和意义也就无法真正明确。(3)确定政策去向与前继环节之间的关系研究虽然发现有40％著作提及有关本环节与政策评价关系的内容，但现有理论对于两个环节之间的具体联系缺乏明确论述，有关政策调整、政策终结与政策评价的关系论述简略，仅在定义中有所提示，此外，缺乏政策法律化与政策评价关系的论述，并且现有理论提示的“政策去向”标准缺乏论述与政策评价联系的思路。故以9分制判断，“确定政策去向”与“政策系统评价”核心目的之间关系的明确程度得分为1-6分之间，平均分为4.2分，待完善程度为33.3％。从得分最高的论述来看，现有理论已经认识到“通过政策评估，人们不仅能够判定某一政策本身的价值，从而决定政策的延续、革新和终结，而且还能够对政策过程的诸个阶段进行全面的考察和分析，总结经验，吸取教训，为以后的政策实践提供良好的基础”，但对于“政策本身价值”与“决定政策的延续、革新和终结”之间的具体联系则普遍缺乏明确阐述。此外，缺乏检验确定政策去向与政策系统评价之间衔接的考核指标和方法，落实衔接的原则和方法也处于空白状态；落实确定政策去向与政策系统评价之间联系的思路不清，现有的步骤也无法保证落实确定政策去向与政策系统评价之间的联系。现有的政策调整相关步骤中对于信息反馈有一定的体现，如“政策调整的程序或功能活动包括了如下几步：第一，获取反馈信息，即掌握由监控机构在政策监督和控制中所获得的关于政策系统运行尤其是政策执行结果方面的信息”，还有“修正程序：信息反馈、修正决策”，这些理论无疑对于从完善联系本环节与“政策系统评价”联系的步骤入手完善“确定政策去向”步骤是有积极意义的，但过于简单和笼统，作用也不是很清楚。(4)确定政策去向内部步骤的逻辑关系现有著作提及步骤理论的比例是55％，但对步骤与本环节核心目的的关系，步骤之间存有什么内在联系则普遍缺乏明确说明，只能依据步骤名称及其阐述内容去推断。以9分制判断，各步骤之间的内在联系的明确程度尚有66.7％。(5)确定政策去向与新一轮政策制定过程的关系确定政策去向的后续环节应是“新一轮政策制定过程”。对40本著作分析后发现，有42.5％的著作提及有关本环节与新一轮政策制定过程关系的内容，其论述集中在政策终结和政策法律化上，也从政策周期理论等其它角度提及了政策过程之间的联系。但分析后发现下列问题：一是政策终结与政策新周期的关系论述缺乏统一，有待明确阐述；二是政策法律化与政策新周期关系着重在政策法律化的意义上，其中的关系同样需要进一步明确；三是部分理论的合理性有待明确阐述。所以，两者之间的关系缺乏明确阐述，仅散在涉及，缺乏系统性。2．确定政策去向环节理论的完善(1)逐项弥补现有缺陷，构建确定政策去向的框架思路和操作步骤针对现有政策学著作在确定政策去向环节阐述的不足、缺陷和空白，逐项进行弥补和完善，并逐步构建形成“确定政策去向”程式。首先，理顺确定政策去向的基本概念，然后在确定环节框架的基础上，明确阐述环节目的及相关理论。其次，构建从环节起点到环节终点层层递进的逻辑框架思路，以便达成确定政策去向目的。第三，依据所形成的框架思路，确定达成环节目的各阶段需要完成的工作，形成和总结“确定政策去向”的基本步骤，吸收评阅著作中的合理部分，借鉴相关学科的有关内容，总结和推荐各步骤的基本思路和常用方法。第四，同样以“逻辑性、科学性、可操作性和合理性”指标体系和标准为框架，在形成确定政策去向各步骤思路和方法的基础上，明确确定政策去向总体及相应步骤中的操作原则，研究者和制定者各自职责、需协调之处、实现双方结合的内容和方法等。(2)确定政策去向理论的完善结果简介本研究认为“政策去向”，即政策的可能归宿可以用政策延续、政策调整、政策法律化和政策终结四个概念加以合理解释，政策去向的基础和前提是“政策系统评价”。简单地说，本环节的目的就是科学地确定政策去向，其中政策去向的选择范围包括政策延续、政策调整、政策法律化和政策终结。在确定政策去向框架思路的构建过程中，本研究明确了建立政策去向标准是科学确定政策去向的基础，为此研制了政策去向标准理论体系，其中包括政策去向变化规律(图2)、“政策价值”影响因素之间及其与“政策去向”决策的逻辑关系(图3)、政策去向判断指标的层次和构建依据、政策去向的具体标准等内容(详细内容请见正文)。根据本环节的框架以及达成目的的框架思路，确定达成本环节目的的步骤如下：信息准备、明确特定政策的基本去向、确定特定政策的去向。具体参见表1。表1归纳了各步骤的名称、基础、主要结果和目的。在表1中三个步骤的总体框架下，进一步运用评价指标体系对确定政策去向总体和各步骤进行了充实完善，完善内容包括思路、操作程序、原则和推荐方法，以及各个步骤中政策研究者、政策实践者的各自的优势和劣势，提供了促进研究者和实践者结合，取长补短的基本思路和方法，其中推荐方法见表1。(3)确定政策去向程式理论的专家评价专家评价结果表明，确定政策去向程式理论在本环节的目的，本环节与政策过程总体关系，本环节与政策系统评价环节关系，本环节的操作思路、步骤、原则与方法，本环节与新一轮政策制定过程关系等方面都比现有政策学著作中确定政策去向相关论述有了较大的提高。专家认为，在判断指标体系中，弥补程度最低的指标完善了23.6％，最高的完善了60.4％，有10％的指标其完善程度在25％以下(包括25％)，70％的指标完善了25％～50％(包括50％)，而20％的指标完善程度达到了50％以上。但是确定政策去向程式理论并非完美，专家评价表明，在各类指标上，确定政策去向程式均有较大的进一步改善的可能空间。例如在可操作性指标上，确定政策去向程式自身的待弥补程度达13.5％-53.1％不等。(二)确定政策去向过程的实证模拟依据本研究所推荐的“确定政策去向程式”，尤其是操作步骤，对“1993年卫生事业单位的工资制度”的归宿展开模拟论证研究，判明该制度的去向。该项研究以我国公立医疗机构工资分配制度的现状为基础展开。研究依据信息准备、明确基本去向和确定该制度去向逐一展开，其中信息准备所占篇幅最大。信息准备阶段中，在熟悉1993年工资制度改革内容等信息基础上，确定了该制度的去向判断指标，进而明确评价阶段相应指标的理论状态或取值，接下来综合运用各种材料收集方法和资料分析方法，以明确“政策去向”指标的实际状态或取值。上述过程基本结果见表2。以表2为基础，可以分析明确，政策的正面价值还是主要的，但同时其带来的问题也不少，程度也较大，“政策解决问题的能力较大而导致的混乱和震荡也较大”，政策基本去向应为政策调整。最后，以立论依据和执行过程指标为突破口，明确了卫生事业单位工资制度改革的潜在具体内容。当然，政策效果和影响中的部分指标也对调整内容也有提示作用。对于公立医疗机构分配制度改革来说，限于各种因素，本研究只能算是基础和初步的研究，但实证模拟过程已能够说明：该程式能够有效指导探讨改革去向的研究和实践，对弥补国内政策学“逻辑性、科学性、可操作性和合理性”四性的缺乏和消除政策的五个效率瓶颈能够起到一定的促进作用。四、研究中的主要探索(一)参与建立了政策学理论的评价指标体系参与建立了判断逻辑性、科学性、可操作性和合理性的指标体系，作为政策学理论规范分析与完善研究的基本工具。(二)明确现有著作确定政策去向环节的缺陷不足运用指标体系，针对政策学著作中确定政策去向环节的相关论述，从总体到各步骤，逐一明确了确定政策去向环节相关论述在逻辑性、科学性、可操作性和合理性上的不足和缺陷，其中主要理论空白12处、理论缺陷28处。(三)针对缺陷不足的弥补和完善针对确定政策去向理论上的不足、缺陷和空白，逐项进行了弥补和完善，对其逻辑性、科学性、可操作性和合理性进行了尽可能的充实。(四)建立了政策去向标准理论体系突破了科学达成环节目的的瓶颈——政策去向标准，系统建立了包括政策去向标准应用思路在内的全套政策去向标准理论体系，为确保整体上达到本环节理论完善目标奠定了基础。(五)总结推荐确定政策去向程式确定政策去向程式理论包括确定政策去向的步骤、各步骤的目的、思路、原则和技术要求，可以成为政策制定者和政策研究者，在开展特定政策的去向研究和改革时的指导性研究方法。(六)对理论研究结果进行了模拟验证运用确定政策去向理论，对“1993年卫生事业单位的工资制度”的归宿进行了研究。模拟过程显示：确定政策去向程式理论在逻辑上严密、操作上简易可行，能够保证研究结果的科学性和合理性。更多还原

【Abstract】 1. Background and Research GoalsThe significance of the policy is indubitable, the quality of the policy can determine whether the cause will prosper or not, and a set of policy theory that can be applied to practice is the important premise of promoting policy-making into scientific track, while scientific policy-making can accelerate the development of policy theory, and then a good mutual relationship can be formed between them. The western policy theory can be traced to 1940’s when it came into being as a independent subject and developed rapidly. And it was introduced to China in the end of 1970’s. At the present time, policy theory in China is still in the phase of introducing, and yet hasn’t finished the process of localization, and we still lack policy methodology research adapting to the situation of China. The above situation results in directly the "bottleneck" which limits the enhancement of the domestic policy value, and it can be described as the following five symptoms in concrete: the disparity between the demand in theory and operation in reality; the disparity between the demand in theory and research in reality; which indirectly cause the following three gaps: the gap between the policy analysts and the policy makers; the gap between research and policy; the gap between policy science and other science.As a necessary link of policy making, policy direction decision-making is generally acknowledged by policy science scholars at home and abroad, so the importance of the related procedures and methods are undoubted. But as same as the current situation of research on policy theory, the domestic research of policy direction decision-making also shows the above five gaps, and it can’t guide effectively policy direction decision-making.With a view to home, the parent project "methodology study of public policy making and research", is aiming at developing scientific policy-making formula that can make the policy research and policy making complement, and providing a whole set of steps and procedures of policy research for the policy makers and policy analysts by focusing on the common objective—how to make hi-valued policy. To achieve the purpose, the parent project reduces the problems existing in the policy theory and practice to nine projects, whichcompose together "the scientific policy-making formula", this project, policy direction decision-making (i.e. summarization and feedback), is located in the graph 1 by shading.The parent study belongs to a theory amelioration study, which was granted by the state distinguished youth fund (79925002) . On the basis of the basic structure of the parent project, this study is exploration about the link of policy direction decision-making. It aims to provide the domestic policy analysts and policy makers a set of formula for policy direction decision-making supporting research and decision-making each other, basing the makeup and amelioration aiming at the defect and shortage of the theory of the policy direction decision-making link existing in the current domestic monographs. The formula includes the train of thought, steps, and the definitions, objectives, basic train of thought, principle and methods in common use of each step, and the chief matter that need attention in each steps, and the advantages and duties of the policy analysts and decision makers, respectively.This study consists of two parts: theory exploration and demonstration-simulation. "The part of theory exploration" emphasizes to manifest the shortage and defect of "policy direction decision-making" in domestic policy science field, and to recommend a set of formula of "policy direction decision-making" supporting research and decision making each other on the basis of making up the shortage and defect. "The part of demonstration-simulation" emphasizes to simulate and validate the recommended formula of "policy direction decision-making" with factual data.2. Research Methodology(1) Theory explorationThe bottleneck and five gaps in policy science that limit policy value can trace to kinds of deficiency of four aspects of "logicality, scientificity, maneuverability and rationality". As a member of task team, I took part in the construction of the indicator system on "logicality, scientificity, maneuverability and rationality" which can be used as the basic criteria for evaluation and improvement of policy science theory including "policy direction decision-making". The indicator system consists of 42 concrete indicators, and conducts theory amelioration study guided by the indicators and their criteria with the method of norm-and-gap analysis.During the period of analyzing the shortage, defects and vacancy about the policy direction decision-making, by comparing the current status of "logicality, scientificity, maneuverability and rationality" with the ideal, the study can judge the disparity and specify the shortage, defects and vacancy. Based on the defects, make up and ameliorate the related theory, and construct the basic frame, the train of thought and steps of the formula of policy direction decision-making. And then apply the above mentioned indicator system to enrich both the whole and each steps of the formula.Experts consultation is used to make judgment on the agreement degree of bug analysis of the research and to evaluate the degree of amelioration on policy direction decision-making theory.The data in theory exploration part is collected by general investigation of all of the policy science monographs published in China by the end of 2004, which is 40 in total.(2) Demonstration-simulationAccording to the formula for the policy direction decision-making recommended by the research, it would make demonstration-simulation researches on the end-result of "salary system of public health institutions of China set up in 1993", whose object was to distinguish its policy direction. The research would base the status quo of salary system of public medical institutions.Main data-collecting methods include subject investigation, routine data collection and intention survey. Methods used in demonstration-simulation include statistic description and statistic test methods, such as average, non-parametric statistics of two independent samples; induction; methods of multivariate statisticalanalysis, such as multiple linear regression, principal component analysis, etc.; literature review and so on.3. The main research results(1) Theory exploration about the link of policy direction decision-making1) The status quo and shortage of the theory of the policy direction decision-making linkAccording to sequence of the indicator system of "logicality, scientificity, maneuverability and rationality", the research evaluated the whole of policy direction decision-making and the four steps of it, viz. information feedback, policy change, policy legislation and policy termination, one by one. The analysis clarified the status quo of the theory of the policy direction decision-making link, and the shortage, defect and aspects which can be ameliorated. Then on the basis of the defect analysis, the degree to improve of the contents in the policy direction decision-making link was identified quantitatively.①The defect in the core goal, the train of thought, steps and methods fulfilling the goal of the policy direction decision-making"Policy direction" normatively expressed is an important and basic premise of manifesting systematism and avoiding aimlessness of policy theory, but there flat exists phenomenon that the diversified concepts in the policy science field remains to be normalized, which is fundamental defect of the policy direction decision-making link. About the core goal of the policy direction decision-making link, over half(57.5%) of the monographs do not mention it, the clear degree of the goal’s narration scores 2.2 on the average, the degree to improve isn’t less than 55.6%. In the current monographs, the most accurate narration appears in the related contents of policy supervision and information feedback, "its aim is to detect warp phenomenon in policy implementation, check and supervise the process of policy implementation, collect timely the data of policy effect, so as to decide whether to continue the implementing policy, or to need revised". Though the narration has a close relationship with "the policy direction decision-making", it is neither accurate nor clear. It only mentions two directions: policy continuance and policy change. So the core goal of the policy direction decision-making link should be depicted clearly on the basis of having defined the policy directions systematically.In addition, it is devoid of systematic indicators of policy directions and scientific criterion for policy directions. The related contents of criterion for policy directions are as follows: they are inducing factors, influencing factors, premise, basis, whys and so on for policy change, definition, basis, form, type, cause, etc. for policy termination, definition and condition for policy legislation. It is found that dispersal and much difference among the contents for the same direction. If estimates the assessment indicator with 9 score method, it’s score ranges from 1 to 4, the average score is 2.2, the degree to improve isn’t less than 55.6%.In terms of the train of thoughts of the policy direction decision-making, besides the above defects, superadded the unclear logical relation between the policy evaluation and policy direction link, this certainly would lead to be absence of systematic cognition and explanation in current policy theory. While it could be found close relation between information feedback and fulfilling the core goal, there was no distinct narration about the train of thoughts of fulfilling the core goal in interrelated contents. Owing to lack guidance of the train of thoughts, it makes the steps recommended by the current monographs lacks the external and internal logicality, then be unable to help to lack the sufficient evidence making the reader carry out the practical policy evaluation complying with fulfilling the core goal of the link.As regards principles in current monographs, there exist two problems: one is that they went without pertinence and the relation between principles and core goal needs explained under the circumstances of unclear core goal; the other is that the contents is too curt and the train of thoughts to put into practice is blurry.Study showed that it can be found methodology contents in the current monographs, but the pertinenceof all methods is unclear. And the issues showing in methods of policy control involved in policy direction decision-making are as follows: first, the relation between the methods and core goal is dark and severely lack pertinence; second, the contents is too curt, without operation point, and the reference clew is also unclear.It is obvious that the interrelated theory of core goal of policy direction decision-making has much shortage, neither analysts nor makers can catch on the core goal of policy direction decision-making link, it goes without saying fulfilling the goal according as the current theory.②The inner relation between policy direction decision-making and procedure of policy making It was found that 52.5 % of 40 monographs mentioned the relation between policy direction decision-making and procedure of policy making after careful search, and they focused the contents on significance, importance and function, etc., so there was no distinct narration about the relation. If estimates the assessment indicator with 9 score method, its score ranges from 1 to 5, the average score is 2.6, the degree to improve isn’t less than 44.4%.The typical related contents mentioned in significance or function of policy change and policy termination are as follows, "policy change is propitious to ameliorate scientifically policy and stabilize policy comparatively; policy termination is propitious to save policy resources, promote policy optimization and improve policy performance"., and so, but they can’t tell the relation between this link and "hi-valued policy making" and even solve policy issues in deed, and exhibit the state of dispersal and aimlessness. The above state means the contribution of the theory of this link to "hi-valued policy making", and even to solve policy, are hardly to illuminate. So the orientation of this link must be vague, and the value and significance of it can’t be delineated clearly yet.③The relation between policy direction decision-making and policy evaluation Study showed that it can be found the contents concerning the relation between policy direction decision-making and policy evaluation in the 40% of current monographs, but there was no distinct narration about the relation between two links, which can be concluded three problems: firstly, the contents about the relation between policy change (policy termination) and policy evaluation is curt, and some clew only can be found in definition; secondly, there was no narration about the relation between policy legislation and policy evaluation; thirdly, the analogous criterion for policy direction decision-making hinted in current theory is found no the train of thoughts of how to associate it with policy evaluation. If estimates the assessment indicator with 9 score method, its score ranges from 1 to 6, the average score is4.2, the degree to improve isn’t less than 33.3%.In the current monographs, the narration of getting maximum score of 6 is as "via evaluation people can not only judge the value of a policy, so as to decide policy direction from continuance, renovation and termination, but also review and analyze comprehensively the whole phases of policy process, summarize experience, assimilate lessons, and lay well groundwork for policy practice later"., but there was no distinct narration about the concrete relation between "policy itself value" and "decide policy direction from continuance, renovation and termination".In addition, it is devoid of indicators and corresponding methods of verifying the link of policy direction decision-making and policy evaluation, and the principles and methods of fulfilling the link is also vacant. At last, the train of thoughts of fulfilling the link is dark, and existing steps can’t ensure fulfilling the link..Current steps of policy change have reflected the information feedback, for instance, "first, to get feedback information, namely detect the information of policy system circulation, especially policy implementation result, during checking and supervising from special institution", "revised procedure:information feedback, revised decision-making"’.. Such theory are good to ameliorate the steps of policy direction decision-making from the start point of ameliorate the step of fulfilling the link between policy direction decision-making and policy evaluation, but too simple and general, the function is also unclear. ?The logical relation among the inner steps of the policy direction decision-making The proportion of the monographs mentioned steps among 40 monographs is 55%, but there is no distinct narration about the relation between each step and core goal of policy direction decision-making link, the relation among steps behaves the same phenomenon, and it can be deduced from step title and its contents. If estimates the assessment indicator with 9 score method, the degree to improve isn’t less than 66.7%. ⑤The relation between the policy direction decision-making and the new procedure of policy making The succeeding link of the policy direction decision-making is "the new procedure of policy making". It was found that 42.5% of 40 monographs mentioned the relation between policy direction decision-making and the new procedure of policy making after careful search, and they focused the contents on policy termination and policy legislation, moreover, the relation between two procedures of policy making is also talked of from the angle of policy cycle theory. But the issues found in it are as follows: first, there exists difference among the contents for the same relation between policy termination and the new procedure of policy making in different monographs, and needs to be formulated; second, the relation between policy legislation and the new procedure of policy making stress the significance of policy legislation, and needs to be formulated, too; third, part of the theory’s rationality needs formulated. So the relation between policy direction decision-making and the new procedure of policy making is unclear and lacks systematism.2) Amelioration of the theory of the policy direction decision-making link①Construction of the train of thought and steps of the policy direction decision-making on the basis of makeup and consummation aiming at the defect and shortageAiming at the shortage, defects and vacancy about the policy direction decision-making in current monographs, make up and ameliorate the related theory, and construct the formula of policy direction decision-making step by step. Above all, the basic concepts of policy directions were defined systematically, and the core goal and its related theory of the link were depicted clear on the basis of the basic frame of the link. Secondly, to fulfilling the goal of the policy direction decision-making, the logistic train of thoughts from the link base was constructed. Thirdly, according the logistic train of thought, the tasks that are necessary to fulfill the goal could be ascertained, and the basic steps of "the policy direction decision-making" could be formed, and then summarized and recommended the basic train of thoughts and methods in common use. Fourthly, applied the indicator system "logicality, scientificity, maneuverability and rationality" to enrich both the whole and each steps of the formula, which included the manipulating principles, the advantages, duties and the place needed to harmony of the policy analysts and decision makers, and the contents and methods of fulfilling the combination of both sides, etc.②Brief introduction of the maim theory research results of the policy direction decision-makingIt is inferred from current policy science theory that policy direction consists of policy continuance, policy change, policy legislation and policy termination, and the foundation and premise of which are "policy evaluation".In a word, the goal of the link is to scientifically decide the policy direction, which ranges from policy continuance, policy change, and policy legislation to policy termination.In the construction process of train of thoughts the policy direction decision-making, the study showed that construction of criterion for policy direction is the foundation of fulfilling the goal, so it constructed the system info of criterion for policy direction, which comprised change law of policy directions (Graph 2), the logistic relation of the influencing factors of “policy value" and policy direction decision-making (Graph 3).hierarchy and construction elements of indicators of policy direction decision-making, the concrete criterion for policy direction decision-making, and so on (refer to text).Graph 2 change law of policy directionsGraph 3 The logistic relation of the influencing factors of "policy value" and policy direction decision-makingAccording to the train of thoughts and the frame of fulfilling the goal of the policy direction decision-making link, the steps were established as follows: information preparation, clarification of basic direction of special policy and policy direction decision-making (Table 1).Table 1 Brief summary of steps and recommended methods of policy direction decision-making link③Expert assessment of the formula for the policy direction decision-makingThe result of the expert assessment indicates that, when regarding the goal of the link, the relation between the link and procedure of policy making, the relation between the link and the policy evaluation, the operational train of thoughts, the steps, the principles and the methods of the link, the relation of between the link and the new procedure of policy making, the theory of the formula for the policy directiondecision-making recommended by the study has been ameliorated fairly on the base of current policy monographs. The study shows that the lowest degree to improve is 23.6%, the highest is 60.4%, and there exists 20% of the indicators whose degree to improve is over 25% (including 25%), 70% of the indicators whose degree to improve ranges from 25% to 50% (including 50%), and 20% of the indicators whose degree to improve exceeds 50%. But the policy evaluation procedure theory is nor perfect, the expert assessment indicates that the theory of the policy direction decision-making still needs to be improved in all indicators. For example, in regard to maneuverability indicators, the degree to improve of the formula for the policy direction decision-making ranges from needed 13.5% -53.1 %.(2) Demonstration-simulation of procedure in the policy direction decision-makingAccording to the recommended formula for the policy direction decision-making, especially the steps, it had made demonstration-simulation researches on the end-result of "salary system of public health institutions of China set up in 1993", whose object was to distinguish its policy direction. The research based the status quo of salary system of public medical institutions.The research was conducted by the sequence of "information preparation, clarification of basic direction of special policy and policy direction decision-making", thereinto, the "information preparation" accounted for the most length. In the phase of information preparation, first of all, it ascertained the indicators of policy direction of given policy on base of having been familiar with the related information of "salary system reform in 1993", second, the theoretical value (range) or state of the indicators are depicted clear, third, the actual value or state of the indicators could be delineated by the means of the methods of investigation and analysis. The above results are shown in Table 2. The results and analysis process indicated that the positive value of policy was dominating, but led to many serious problems, "the ability of solving issues was great, at the same time the extent of chaos and shock is also great", so the basic direction of the system was policy change. At last, the latent concrete contents of salary system reform of public health institutions were briefly introduced by the indicators of implementation process and policy origin, of course, part of the indicators of policy effect and influence also could provide clue to ascertain the contents of policy change.No doubt that the research is only the fundamental and preparatory study for distribution system of public medical institution owing to different factors, however, the simulation process shows that the formula can guide the research and practice of policy direction decision-making effectively, and has manifested the promotion function of making up the deficiency of four aspects of "logicality, scientificity, maneuverability and rationality" and removing the "five bottleneck" of influencing policy efficiency.Table 2 The theoretical and actual value or state of the direction indicators of the salary system of publichealth institutions of China set up in 19934. The main exploration of the study(1) Take part in construction of the indicator system for appraising the policy science theoryThe task team constructed the indicator system on "logicality, scientificity, maneuverability and rationality" which was used as the basic tools to evaluate normally and ameliorate the policy science theory.(2) Specify the defect and shortage of the theory of the policy direction decision-making link in thecurrent monographsAccording to the indicator system, the research evaluated the whole and steps directing at the related narration about the policy direction decision-making link in the current policy monograph, specified the defects and shortage of the related contents in the logicality, scientificity, maneuverability, and rationality, one by one, among which the number of theory vacancy is 12, and the theory defect is 28.(3) Makeup and amelioration aiming at the defect and shortageAiming at the shortage, defects and vacancies in theory about "the policy direction decision-making", make up and ameliorate them one by one, and then enrich the theory of policy direction decision-making in its logicality, scientificity, maneuverability, and rationality as far as possible.(4) Construction of system info of criterion for policy directionThis research broke through the bottleneck, criterion for policy direction decision-making, of fulfilling the goal of the link, had constructed the complete set of system info of criterion for policy direction, including application train of thoughts, laid the foundations of insuring achieving the theory amelioration objects.(5) Summarize and recommend the formula for the policy direction decision-makingThe formula for the policy direction decision-making includes the steps, and the object, train of thoughts, principle and technical demand of each step, and the theory can become the instructional research method for the policy makers and policy analysts when they carry out the policy direction decision-making research and reform for specific policy.(6) Demonstration-simulation of the theory research resultsAccording to the formula for the policy direction decision-making, it had made researches on the end-result of "salary system of public health institutions of China set up in 1993". The simulation result shows that the formula is strict in logicality, easy and practical to operate, and can guarantee the scientificity and rationality of the research results.更多还原