| 引用本文：崔兆涵, 王叶, 申红娟, 马亚洁, 吴记先, 张瑞红, 王会涛.乡村医生的脱嵌困境与紧密型医共体框架下的再嵌入机制研究[J].中国卫生政策研究,2024,17(12):7-13 |
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| 乡村医生的脱嵌困境与紧密型医共体框架下的再嵌入机制研究 |
| 投稿时间：2024-09-29 修订日期：2024-11-12 PDF全文浏览 HTML全文浏览 |
| 崔兆涵1,2, 王叶3, 申红娟3, 马亚洁3, 吴记先3, 张瑞红3, 王会涛3 |
1. 南京医科大学医政学院 江苏南京 211166;
2. 南京医科大学数智技术与健康治理实验室 江苏南京 211166;
3. 唐县人民医院 河北保定 072350 |
| 摘要:在健康中国战略与乡村振兴战略全面推进的背景下，乡村医生队伍的稳定与健康发展极其重要。我国乡村医生发展面临“脱嵌”困境，而紧密型医共体建设为解决乡村医生脱嵌困境提供了契机。本文基于嵌入性理论，对乡村医生面临的结构脱嵌、关系脱嵌、认知脱嵌困境进行解构，并对县域医共体解决乡村医生脱嵌困境的作用机制进行了理论分析，进一步运用唐县医院集团案例进行阐释。研究发现，县域医共体能够通过组织整合机制、利益协调机制、多元激活机制实现乡村医生的结构再嵌入、关系再嵌入与认知再嵌入；组织整合下行政手段与经济手段相结合是促进乡村医生再嵌入的基础；乡村医生的再嵌入需要县域医共体内外部变革的协同；多元激活机制是促进乡村医生再嵌入的内生性动力；乡村医生结构、关系、认知再嵌入之间存在递进与耦合关系。 |
| 关键词:乡村医生 紧密型县域医共体 脱嵌 再嵌入 |
| 基金项目:教育部人文社会科学研究青年基金项目(23YJCZH030)；江苏省高校哲学社会科学研究一般项目(2023SJYB0291) |
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| Research on the disembedding dilemma of rural doctors and the re-embedding mechanism under the framework of the merged county medical alliance |
| CUI Zhao-han1,2, WANG Ye3, SHEN Hong-juan3, MA Ya-jie3, WU Ji-xian3, ZHANG Rui-hong3, WANG Hui-tao3 |
1. School of Health Policy & Management, Nanjing Medical University, Nanjing Jiangsu 211166, China;
2. Laboratory for Digital Intelligence & Health Governance, Nanjing Medical University, Nanjing Jiangsu 211166, China;
3. Tang County People's Hospital, Baoding Hebei 072350, China |
| Abstract:Against the backdrop of the comprehensive advancement of the Healthy China Strategy and the Rural Revitalization Strategy, the stability and healthy development of the rural medical workforce have become increasingly significant. China's rural doctors are facing the dilemma of “disembedding” and the construction of the merged county medical alliance(MCMA) offers an opportunity to address this issue. Based on the theory of embeddedness, this paper deconstructs the structural disembedding, relational disembedding, and cognitive disembedding faced by rural doctors, and provides a theoretical analysis of the mechanisms through which MCMA can solve the disembedding dilemma of rural doctors. Furthermore, the case of Tang County Hospital Group is used to illustrate this. The conclusion can be drawn that MCMA can achieve the structural re-embedding, relational re-embedding, and cognitive re-embedding of rural doctors through organizational integration mechanisms, interest coordination mechanisms, and multifaceted activation mechanisms. The combination of administrative and economic means under organizational integration is the foundation for promoting the re-embedding of rural doctors. The re-embedding of rural doctors requires the synergy of internal and external changes within the MCMA. Multifaceted activation mechanisms are the endogenous driving force for the re-embedding of rural doctors. There is a progressive and coupled relationship between the structural, relational, and cognitive re-embedding of rural doctors. |
| Key words:Rural doctors Merged county medical alliance (MCMA) Disembedding Re-embedding |
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