中国农村卫生事业管理2026，Vol.46Issue(5)：325-331,7.DOI:10.19955/j.cnki.1005-5916.2026.05.004
基于修正后模糊冲突模型的我国门诊共济政策执行困境研究
The execution dilemma of the outpatient mutual-aid policy in China based on the modified fuzzy conflict model
蒋泽稀 1冯毅翀 2李悦鸣 2邬卫东3
作者信息
- 1. 贵州大学医学院,贵州 贵阳 550025
- 2. 贵州中医药大学人文与管理学院
- 3. 贵州中医药大学
- 折叠
摘要
Abstract
Objective To analyze the constraining factors in the implementation of the outpatient mutual-aid policy in China,aiming to provide a theoretical foundation for optimizing the effectiveness of policy im-plementation.Methods Based on the revised"ambiguity-conflict"theoretical framework,an analytical matrix was constructed for the textual analysis of documents of the outpatient mutual-aid policy and feedback data at the municipal level and above since the 2021 healthcare reform.Results The policy conveyance stage was character-ized by decreasing ambiguity and increasing conflict,prompting political implementation;the policy deepening stage saw a simultaneous reduction in both,shifting the model to administrative execution.Conclusions The cur-rent policy follows an administrative execution model,with resource assurance as its main constraint.The imple-mentation faces challenges such as policy ambiguity,institutional fragmentation,worsening imbalance in resource allocation,tests of legitimacy and effectiveness,and gaps between administrative actions and social demands.To ensure the effective implementation of the outpatient mutual-aid policy,it is suggested to build a collaborative poli-cy adaptation system,innovate financial resource allocation and compensation mechanisms,establish a multi-di-mensional effectiveness assessment system,and create a governance ecosystem that fosters collaboration between government and society.关键词
卫生政策/政策执行/"模糊—冲突"模型/职工医保/个人账户/门诊共济政策Key words
Health policy/Policy implementation/Ambiguity-conflict model/Employee medical insur-ance/Individual account/Outpatient mutual-aid policy分类
医药卫生引用本文复制引用
蒋泽稀,冯毅翀,李悦鸣,邬卫东..基于修正后模糊冲突模型的我国门诊共济政策执行困境研究[J].中国农村卫生事业管理,2026,46(5):325-331,7.
