摘要
目的:从政策工具视角分析县域医共体政策体系的特点与结构,为县域医共体建设实践和后续政策的制定与调整提供参考。方法:对2016-2023年中央政府层面颁布的县域医共体相关政策文件进行梳理,基于政策工具视角,构建“基本政策工具(X维度)-整合型医疗卫生服务框架(Y维度)”二维政策工具分析框架,对县域医共体政策工具使用情况进行分析。结果:共纳入44份政策文件,累计政策编码212条。在X维度,需求型、供给型和环境型政策工具的使用比例分别为14.62%、34.91%和50.47%。在Y维度,系统整合、组织整合、专业整合、服务整合和支持要素整合环节政策工具的使用占比分别为31.60%、19.34%、7.08%、19.34%和22.64%。结论:需适度提高需求型政策工具的应用,并进一步优化政策工具内部结构;根据县域医共体发展阶段,动态运用政策工具;加强政策工具在专业整合环节的实施力度,提高政策工具的系统性;县级医院应在政策工具的协同效应下发挥“龙头作用”。
Objective:To analyze the characteristics and structure of county-level medical cluster policy systems from the perspective of policy tools,providing references for the construction of county-level medical clusters as well as the formulation and adjustment of subsequent policies.Methods:Policy documents related to county-level medical clusters issued by the central government from 2016 to 2023 were reviewed.Based on the perspective of policy tools,a two-dimensional analytical framework of“basic policy tools(X dimension)–integrated health service framework(Y dimension)”was constructed to analyze the application of policy tools in county-level medical cluster policies.Results:A total of 44 policy documents were included,with 212 policy codes generated.In the X dimension,the usage proportions of demand-oriented,supply-oriented,and environmental policy tools were 14.62%,34.91%,and 50.47%,respectively.In the Y dimension,the proportions of policy tools used in system integration,organizational integration,professional integration,service integration,and supporting element integration were 31.60%,19.34%,7.08%,19.34%,and 22.64%,respectively.Conclusion:It is necessary to moderately increase the application of demand-oriented policy tools and further optimize the internal structure of policy tools.Policy tools should be dynamically applied according to the development stages of county-level medical clusters.Greater emphasis should be placed on professional integration,and county hospitals should play a“leading role”under the synergy of policy tools.
作者
刘曦
李贞
冯启明
赵劲民
LIU Xi;LI Zhen;FENG Qiming;ZHAO Jinmin(Center for Health Policy Research,Guangxi Medical University,Nanning,Guangxi Zhuang Autonomous Region,530021,PRC)
出处
《中国医院》
北大核心
2025年第10期40-44,共5页
Chinese Hospitals
基金
广西自然科学基金项目(2020JJB180002)。
关键词
县域医共体
整合型医疗卫生服务
政策工具
政策文本
county-level medical cluster
integrated health service
policy tools
policy texts
作者简介
通信作者:赵劲民,广西医科大学卫生与健康政策研究中心教授,E-mail:zhaojinmin@126.com。
