Abstract: The essence of purchasing health service is a separation of buying and supply， and a term of payment based on performance. In the recent years， this practice has developed very quickly in China， whose purchase modes include voucher system， internal contract and outsourcing contract. Based on the five typical cases in Chongqing， Weifang， Hefei， Suzhou and Wuxi， it is found that the three health service purchase modes have all improved dramatically in terms of the public， the government and the community health organizations. Because health service purchase is a complicated arrangement， there still exist some challenges and problems in the process. To improve the effectiveness of health service purchase， it is essential to choose the purchase modes and service providers according to the actual situations， determine the pricing and compensation systems reasonably， strengthen the assessment and supervision， and introduce the appropriate competition mechanisms.

Key words: government purchase, public service, community health