| 引用本文：李阳, 段光锋, 田文华, 张嵬, 龙俊睿, 孙自学.构建分级诊疗体系的政策工具选择——基于省级政府政策文本的量化分析[J].中国卫生政策研究,2018,11(1):48-52 |
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| 构建分级诊疗体系的政策工具选择——基于省级政府政策文本的量化分析 |
| 投稿时间：2017-07-04 修订日期：2017-11-28 PDF全文浏览 HTML全文浏览 |
| 李阳1, 段光锋1, 田文华2, 张嵬1, 龙俊睿1, 孙自学1 |
1. 第二军医大学卫生勤务学系 上海 200433;
2. 复旦大学社会发展与公共政策学院 上海 200433 |
| 摘要:目的：比较分析国内各省市在分级诊疗制度建设中政策工具的选择和应用情况，为提高分级诊疗政策执行的有效性提供建议。方法：通过互联网检索各省级政府关于分级诊疗的政策文件，以Rothwell&Zegveld政策工具划分为基础，综合政策文本的归纳和专家意见，归并整理政策工具名称和类别，计算各种政策工具使用的频数，分析政策工具的使用情况。结果：收集了30个省级政府的分级诊疗政策文件，归纳整理出供给型、需求型和环境型3个类别15种政策工具。供给型政策工具占32.92%，需求型政策工具占20.58%，环境型政策工具占46.50%。应用最多的政策工具是法规管制，应用最少的政策工具是病种目录。结论：在政策工具选择上以环境类政策工具应用最多，需求类政策工具应用最少，且以强制性政策工具占主导；东部地区三类政策工具的使用较为均衡，中部地区需求类政策工具使用相对较少，西部地区主要以环境类政策工具为主，而需求类政策工具匮乏。在分级诊疗政策执行过程中应重视政策工具的研究，以适宜的政策工具促使政策目标的达成。 |
| 关键词:分级诊疗 政策工具 政策文本 量化分析 |
| 基金项目:国家自然科学基金项目（71603270；71373279） |
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| Selection of policy tools for constructing tiered medical care system: A Quantitative analysis based on provincial government policy text |
| LI Yang1, DUAN Guang-feng1, TIAN Wen-hua2, ZHANG Wei1, LONG Jun-rui1, SUN Zi-xue1 |
1. Faculty of Military Health Service, Second Military Medical University, Shanghai 200433, China;
2. School of Social Development and Public Policy, Fudan University, Shanghai 200433, China |
| Abstract:Objective:To compare and analyze the choice and application of policy tools in the construction of hierarchical medical system in different provinces of china, and to provide advice for improving the effectiveness of the hierarchical medical policy implementation. Methods:Retrieve the policy documents of provincial governments on hierarchical medical policy through internet search; sort names and categories of policy tools based on the classification of policy tools by Rothwell&Zegveld after consulting the expert, and analyze the use of policy tools by calculating the frequency of different policy tools. Results:This study has summed up 15 types of policy tools in 3 categories including demand, supply, and environment of provincial hierarchical medical policy. Supply policy tools accounted for 32.92%, demand policy tools accounted for 20.58%, and environmental policy tools accounted for 46.50%. The most widely used policy tool is the regulatory control, and the least used policy tool is the disease catalog. Conclusions:Among the choice of policy tools, the category of environmental policy tools are the most widely used, and demand policy tools are applied the least. The use of three types of policy tools in the eastern region are balanced, the demand policy tools in Central China are relatively few, and the environmental policy tools are widely used in the western region, while the demand oriented policy tools are scarce. |
| Key words:Hierarchical medical Policy tools Policy texts Quantitative analysis |
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