| 引用本文：郝思凯.家庭医生签约服务政策的变迁逻辑与高质量发展路径研究——基于政策整合的分析框架[J].中国卫生政策研究,2025,18(4):9-17 |
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| 家庭医生签约服务政策的变迁逻辑与高质量发展路径研究——基于政策整合的分析框架 |
| 投稿时间：2025-04-03 PDF全文浏览 HTML全文浏览 |
| 郝思凯 |
| 中国人民大学公共管理学院 北京 100872 |
| 摘要:目的:探讨我国家庭医生签约服务政策的多层次变迁逻辑,为其高质量发展提供路径建议。方法:基于政策整合理论构建分析框架,通过内容分析法与政策网络分析法,应用Nvivo及Gephi软件对346份家庭医生签约服务政策文本进行跨文本、跨阶段的主题编码与比较研究,旨在提炼和总结政策变迁的理论逻辑。结果:我国家庭医生签约服务政策的变迁过程可划分为试点探索、全面推广和提质增效三个阶段。从其变迁逻辑来看,政策框架实现了从工具性政策向综合型议题的转变；子系统参与从单一卫健部门主导转向多元主体的协同共治；政策目标度由医疗服务能力提升发展为多领域嵌入与深度融合；政策工具维度从分散化探索发展为结构化部署。结论与建议:为实现家庭医生签约服务的高质量发展,应强化价值整合,构建签约服务的战略管理框架；加强央地协同,实现签约服务模式的迭代创新；注重反馈整合,健全签约服务的整合评估体系；推动技术整合,助推签约服务的智能化转型。 |
| 关键词:政策整合 家庭医生签约服务 政策变迁 高质量发展 |
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| The logic of change and high-quality development pathways for family doctor contract service policies in China:An analytical framework based on policy integration |
| HAO Si-kai |
| School of Public Administration and Policy, Renmin University of China, Beijing 100872, China |
| Abstract:Objective:To investigate the multi-level logic of change in China's family doctor contract service policies and propose pathways for their high-quality development. Methods:An analytical framework grounded in policy integration theory was developed. Through content analysis and policy network analysis, 346 policy documents on family doctor contract services were analyzed using Nvivo and Gephi software, with cross-text and cross-stage thematic coding to identify patterns of policy change. Results:The policy change process can be categorized into three phases:pilot exploration, nationwide implementation, enhance quality and efficiency. Key trends include:Policy frameworks transitioned from instrumental issue to comprehensive agendas; Policy subsystem participation shifted from unilateral leadership by health departments to multi-stakeholder collaboration; Objectives expanded from healthcare capacity-building to systemic integration across domains; Policy instruments evolved from fragmented trials to structured systems. Conclusion and Recommendations:To advance high-quality development, policymakers should:Strengthen value integration through strategic governance frameworks;Enhance coordination between central and local governments to drive iterative innovation in contract-based service models; Implement feedback integration with multidimensional evaluation mechanisms ;Accelerate technical integration via digital transformation. |
| Key words:Policy integration Family doctor contract services Policy change High-quality development |
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