| 引用本文：陈荣,赵君,刘思琦,等.老年人对居家社区医养结合服务满意度的核心节点与桥梁节点识别基于同期网络分析[J].中国卫生政策研究,2025,18(12):67-82 |
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| 老年人对居家社区医养结合服务满意度的核心节点与桥梁节点识别基于同期网络分析 |
| 投稿时间：2025-11-22 修订日期：2025-12-10 PDF全文浏览 HTML全文浏览 |
| 陈荣1，赵君1，刘思琦1,2，王芳1,2 |
| 1.中国医学科学院/北京协和医学院医学信息研究所/图书馆 北京 100020;2.中国医学科学院/北京协和医学院卫生健康管理政策学院 北京 100005 |
| 摘要:目的 探究我国老年人对居家社区医养结合服务不满意项之间的内在联系，识别满意度的核心节点与关键干预靶点。方法 采用目的抽样法对7个省（市）6 844名接受过服务的老年人进行问卷调查。运用同期桥接网络分析方法，构建以不满意项为节点的网络，分析其条件依赖关系，并计算节点的度数中心度和桥接强度。结果 网络分析显示，各不满意项间存在紧密关联。“服务内容不满意”的度数中心度最高（rs=8.21），是网络核心节点；“服务机构离家远”的桥接强度最高（rbs=5.96），是连接“服务可及性差”与其他维度的关键桥梁。最强的边连接存在于“收费不满意”与“服务内容不满意”之间（b=3.10）。结论 老年人对居家社区医养结合服务的满意度问题是一个相互关联的系统。提升满意度需优先干预“服务内容不满意”这一核心矛盾，并重点改善“服务机构离家远”等影响多维度的可及性问题，以优化服务供给结构，实现精准施策。 |
| 关键词:居家社区医养结合 满意度 桥接网络分析 |
| 基金项目:中国医学科学院医学与健康科技创新工程项目（2021-I2M-1-046）；国家卫生健康委委托项目“2024年社区医养结合能力提升行动” |
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| Identification of core and bridge nodes for elderly people's satisfaction with home- and community-based integrated health and social care： A contemporaneous network analysis |
| CHEN Rong1, ZHAO Jun1, LIU Si-qi1,2, WANG Fang1,2 |
| 1.Institute of Medical Information and Library， Chinese Academy of Medical Sciences & Peking Union Medical College， Beijing 100020， China;2.School of Health Policy and Management， Chinese Academy of Medical Sciences & Peking Union Medical College， Beijing 100005， China |
| Abstract:Objective To explore the interrelationships among dissatisfaction items regarding home- and community-based integrated health and social care for older adults in China， and to identify the core nodes and key intervention targets for satisfaction.Methods A purposive sampling method was used to survey 6 844 services recipients from seven provinces/cities. A contemporaneous bridging network was constructed with dissatisfaction items as nodes to analyze their conditional dependencies and compute node strength and bridge strength.Results The network analysis revealed close connections among dissatisfaction items. "Dissatisfaction with service content" had the highest strength centrality （rs=8.21） and was identified as the core node， whereas "long distance to service institutions" showed the highest bridging strength （rbs=5.96）， serving as a key bridge linking "poor service accessibility" and other domains. The strongest edge was between "dissatisfaction with costs" and “dissatisfaction with service content” （b=3.10）.Conclusions Satisfaction issues among older adults regarding home- and community-based integrated health and social care form an interconnected system. Improving satisfaction requires prioritizing interventions on "dissatisfaction with service content" as the core contradiction， while emphasizing enhancements to multi-dimensional accessibility issues such as "long distance to service institutions" to optimize service supply structures and enable targeted policies. |
| Key words:Home- and community-based integrated health and social care Satisfaction Bridging network analysis |
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