基于扎根理论的社区医养结合服务公私合作模式研究  

Research on public-private partnership model of integrated medical and elderly healthcare services in the community based on grounded theory

作　　者：王晓晓 刘新功 郭清[3] 陈雅婷[1] 边森森 司建平 任建萍[1] WANG Xiao-xiao;LIU Xin-gong;GUO Qing;CHEN Ya-ting;BIAN Sen-sen;SI Jian-ping;REN Jian-ping(Medical School,Hangzhou Normal University,Hangzhou Zhejiang 311121,China;Health Bureau of Gongshu District,Hangzhou Zhejiang 310015,China;Zhejiang Chinese Medical University,Hangzhou Zhejiang 310053,China)

机构地区：[1]杭州师范大学医学院,浙江杭州311121 [2]杭州市拱墅区卫生健康局,浙江杭州310015 [3]浙江中医药大学,浙江杭州310053

出　　处：《中国卫生政策研究》2020年第12期54-60,共7页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(71774147);杭州市哲学社会科学规划课题成果(M21JC094)。

摘　　要：目的:探讨社区医养结合服务公私合作模式的动因、策略和障碍,为我国社区医养结合服务供给侧改革提供参考。方法:运用扎根理论法,聚焦社区医养结合服务公私合作的典型案例,借助Nvivo12质化分析软件对相关主体的访谈记录及政策文本资料进行编码和分析。结果:经过开放性编码、主轴性编码及选择性编码,共得到51个初级概念、12个范畴和3个主范畴。根据扎根理论“条件—现象—行动/互动策略—结果”的典范模型,自下而上建构起社区医养结合服务公私合作的理论模型。结论:社区医养结合服务公私合作的动因包括老年人医养需求高、国家政策导向和地方政府推动;合作的策略包括建立伙伴关系、资源整合与共享、动员老年人参与;合作的障碍有体制困境、双方信任缺失、基层服务能力有限、激励不到位、公益性与趋利性的矛盾、缺少第三方监督评估。Objective:To explore the motivations,strategies and obstacles of the public-private partnership model of integrated medical and elderly healthcare services in the community,and to provide references for the reform of supply-side in China.Methods:The grounded theory methods were used,typical cases of public-private partnership in the community's integrated medical and elderly healthcare services were emphasized,and NVivo12 qualitative analysis software was used to encode and analyze the interview records and policy texts of relevant subjects.Results:After open coding,main axis coding and selective coding,a total of 51 primary concepts,12 categories and 3 main categories were obtained.Based on the model of Grounded Theory“conditions-phenomenon-actions/interaction strategies-results”,a theoretical model of public-private partnership of the community integrated medical and elderly healthcare services was constructed from the bottom up.Conclusions:The motivations of public-private partnership in community integrated medical and elderly healthcare services include high demand for medical and elderly healthcare,national policy guidance and local government promotion.The cooperation strategies include the establishment of partnerships,resource integration and sharing,and mobilization of elderly participation.Barriers to cooperation are institutional difficulties,lack of trust between parties involved in the agreements,limited grassroots service capabilities,inadequate incentives,contradictions between public welfare and profitability,and lack of third-party supervision and evaluation.

关 键 词：社区医养结合服务 公私合作 扎根理论 

分 类 号：R197[医药卫生—卫生事业管理]