中国全科医学2024，Vol.27Issue(25)：3100-3107,8.DOI:10.12114/j.issn.1007-9572.2023.0741
基于三维分析框架的我国家庭医生签约服务政策量化研究
Quantitative Analysis of China's Contracted Family Doctor Service Policies Based on a Three-dimensional Analysis Framework
摘要
Abstract
Background After being completely promoted for less than seven years,China's contracted family doctor service work still faces a number of development problems.The primary obstacle impeding the work of contracted family doctor service is an inadequate guarantee mechanism.There is an urgent need for scientific and reasonable policies on contracted family doctor service to guarantee the effective development of the work.Objective To quantitatively analyze the textual content of China's contracted family doctor service policies,to explore the focus and shortcomings of the existing policies,and to provide the basis and reference for the development and optimization of the subsequent contracted family doctor service policies.Methods Policy texts were collected by visiting the official websites of the China government and the National Health Commission of the People's Republic of China on 2023-01-10,and 15 policy texts on contracted family doctor service from 2015-2022 were selected to construct a three-dimensional analytical framework of policy tools-stakeholders-policy strength,to categorize,code,and analyze the policy documents.Results Supply-based,demand-based,and environment-based tools accounted for 30.5%(69/226),19.0%(43/226),and 50.5%(114/226)of the policy tool dimension.Family doctors,contractors,non-contractors,primary medical and health care institutions,hospitals(secondary and above),and the government accounted for 29.2%(123/422),14.7%(62/422),9.2%(39/422),21.3%(90/422),13.3%(56/422),and 12.3%(52/422)of the stakeholder dimension.The average strength of China's contracted family doctor service policies was 2.2 points.In the cross-dimension of policy tools-stakeholders,the distribution of stakeholders in supply-based and environment-based tools was relatively poor.There were some sub-tools that were absent from the policy tools.In the cross-dimension of policy tools-policy strength,environment-oriented policy instruments were used more often as policy strength increased.In the cross-dimension of stakeholders-policy strength,there were large differences of the policy strength matching scores among various stakeholders.Family doctors had the highest score(311 points)with non-contractors the lowest score(90 points).Conclusion From the perspective of policy tools,policy tools should be allocated rationally,with the weight of use continuously adjusted,the internal structure optimized,and the rationality of the distribution of policy tools among stakeholders improved.From the stakeholder's perspective,all stakeholders should be taken into account,their respective positions need to be clarified,and the demand of the non-contractors should be emphasized.From the perspective of policy strength,the policy supervision and management capacity ought to be strengthened to continuously improve the implementation of the policy of contracted family doctor service.关键词
家庭医生签约服务/政策工具/利益相关者/政策力度/政策分析Key words
Contracted family doctor services/Policy tools/Stakeholders/Policy strength/Policy analysis分类
医药卫生引用本文复制引用
孙嘉颖,罗金萍,张倩雯,王康,尹文强,陈钟鸣,马东平..基于三维分析框架的我国家庭医生签约服务政策量化研究[J].中国全科医学,2024,27(25):3100-3107,8.基金项目
国家自然科学基金青年基金资助项目(72004164) （72004164）
