| 引用本文：李志远,季惠斌,李姗,等.新医改以来公立医院补偿机制改革政策的主题识别与演化分析[J].中国卫生政策研究,2025,18(7):9-17 |
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| 新医改以来公立医院补偿机制改革政策的主题识别与演化分析 |
| 投稿时间：2025-06-24 修订日期：2025-07-12 PDF全文浏览 HTML全文浏览 |
| 李志远，季惠斌，李姗，吴华章 |
| 中国医科大学健康管理学院 辽宁沈阳 110122 |
| 摘要:目的 分析新医改以来我国公立医院补偿机制改革政策主题的分布特点及演化趋势，为正确认识公立医院补偿机制改革的基本内涵和外延提供参考。方法 收集国家层面出台的75份文件，利用BERTopic主题模型进行主题识别，利用BERTopic动态主题建模方法进行政策演化分析。结果 新医改以来公立医院补偿机制改革政策可分为加强公立医院运营管理、调整医疗服务价格等8个主题，并呈现出初期强调控制医疗费用过快增长和落实政府投入责任、中期聚焦取消药品加成和调整医疗服务价格、后期强化医保支付方式改革的演化趋势。结论 公立医院补偿机制改革本质上是公立医院运行机制的系统性重构，而调整优化医疗服务价格和改革医保支付方式是完善公立医院补偿机制的关键和重点。 |
| 关键词:公立医院 补偿机制改革 BERTopic模型 政策文本分析 |
| 基金项目:辽宁省教育厅科学研究项目（QNRW2020007） |
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| Theme identification and evolution analysis of compensation mechanism reform policy in public hospitals since the new healthcare reform |
| LI Zhi-yuan, JI Hui-bin, LI Shan, WU Hua-zhang |
| School of Health Management，China Medical University， Shenyang Liaoning 110122， China |
| Abstract:Objective To analyze the thematic distribution characteristics and evolution trends of the compensation mechanism reform policies for public hospitals in China since the new healthcare reform， and to provide references for correctly understanding the basic connotation and extension of the reform of compensation mechanism.Methods A total of 75 documents issued at the national level were collected. The BERTopic topic model was used for thematic identification.The dynamic topic modeling method of BERTopic was adopted to conduct policy evolution analysis.Result Since the new medical reform， the reform policy of compensation mechanism in public hospitals can be divided into eight themes， such as strengthening the operation management of public hospitals and adjusting the price of medical services.It shows an evolutionary trend of emphasizing the control of excessive growth of medical expenses and the implementation of government investment responsibilities in the early stage， focusing on the elimination of drug additions and the adjustment of medical service prices in the middle stage， and strengthening the reform of medical insurance payment methods in the later stage.Conclusions The reform of the compensation mechanism for public hospitals is essentially a systematic reconstruction of the operation mechanism of public hospitals. Adjusting and optimizing medical service prices and reforming the medical insurance payment method are the key and focus of improving the compensation mechanism for public hospitals. |
| Key words:Public hospitals Compensation mechanism reform BERTopic model Policy text analysis |
| 摘要点击次数: 97 全文下载次数: 28 |
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