健康整合理论溯源及研究方法评价  

The Origin and Research Methods on Integrated Health

作　　者：唐文熙[1,2] 张研[1,2] 施萌[1,2] 张亮[1,2] 

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,武汉430030 [2]湖北省人文社科重点研究基地农村健康服务研究中心,武汉430030

出　　处：《医学与社会》2014年第8期13-17,共5页Medicine and Society

基　　金：国家自然科学基金"基于CAS理论的农村医疗服务纵向整合管理模型研究"项目;编号为71273099;美国中华医学会"整合卫生服务的效率与效果研究"项目;编号为11-069

摘　　要：随着医学和健康服务体系从还原转向整体、分化转向整合,卫生研究方法也从简单转向复杂。虽然,中国正式引入复杂性科学不到20年,但卫生领域急需整合的现实需求促使其理论不断被应用和深化,其中复杂自适应系统是应用较多的理论。文章论述了卫生系统的复杂性问题,证明了系统论观点运用在卫生领域的正当性,介绍了国内卫生研究领域运用复杂性理论的情况,并对复杂自适应理论假设前提在卫生系统的适用性进行了辨析。卫生系统的复杂性主要来自多个利益相关者的复杂博弈,但是,不是所有的主体都具有高度的自适应性。卫生系统是组织系统和自组织系统的结合,所以纯定量方法不能完全应用于政策和管理的循证,而基于利益相关者的动态博弈理论结合了定性和定量的优势,有助于非线性研究的突破,因此该理论也成为健康整合的主要研究方法。The methods of health research have become ＂ complexness＂ from ＂ simplexes＂ by the ＂ deoxidation＂ and ＂ differentiation＂ of health system turning to ＂integration＂. Although the duration of importing complexity science in China are less than 20 years, the need of integra- tion in health field make the theory more and more deep going. Complex adaptive system （CAS） is relatively popular in these theories. This paper has discussed the complex question of health system and proved the adaptability of system theory applying to health field ; meanwhile, the paper has introduced the condition of applying complex theory in health research ; At last, this paper has discriminated the adaptability of premise of CAS in health system. Health system is very complex because of the game between of stakeholders, and not all the stakeholders are adaptive, so quan- titative research methods canl apply to evidence - based policy and management very compatibly. As a result of dynamic game theory between stakeholders combines the advantages of quantitative and qualitative research, this theory becomes the main method of researching Integrated Health.

关 键 词：健康整合 复杂性 复杂系统论 复杂自适应系统 

分 类 号：R197.1[医药卫生—卫生事业管理]