医疗联合体网格化管理政策执行的关键问题及推行策略分析  

Analysis of key issues and implementation strategies for grid management policy of the medical alliances

作　　者：丰志强 尹文强[2] 孟翠香 郭洪伟[2] 张玉杰 马东平 Feng Zhiqiang;Yin Wenqiang;Meng Cuixiang;Guo Hongwei;Zhang Yujie;Ma Dongping(School of Public Health and Management,Weifang Medical University,Weifang 261053,China;School of Management,Weifang Medical University,Weifang 261053,China)

机构地区：[1]潍坊医学院公共卫生学院,261053 [2]潍坊医学院管理学院,261053

出　　处：《中华医院管理杂志》2021年第2期89-93,共5页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金(71373182,71804131);山东省自然科学基金(ZR2019MG010)。

摘　　要：目的对山东省日照市医疗联合体(以下简称医联体)网格化布局管理策略进行分析,为该政策完善提供借鉴。方法2020年8月,就医联体网格化布局管理目标、具体措施、存在问题及影响因素等,对山东省日照市31名相关管理者进行半结构化访谈。运用扎根理论梳理访谈资料,结合梅兹曼尼安-萨巴提尔政策执行综合模型进行深入分析。结果通过分析,获得理论和技术支撑、目标群体特征、政策因果论、政策指令现状、执行机构间关系、社会经济条件和技术、公众态度以及媒体宣传8个主范畴及19个副范畴。在此基础上,基于梅兹曼尼安-萨巴提尔政策执行综合模型形成了医联体网格化管理政策执行理论框架。结论该市执行医联体网格化管理政策的社会经济条件和技术较为成熟,公众支持力度高、社会反响好,但仍存在政策指令不够清晰、不同主体间利益协同机制不完善和配套政策不完备等问题。未来应促进形成政策执行合力、出台配套政策并加强基层队伍建设等,以保障政策的有序推进与长效实施。Objective To analyze the grid management strategy of medical alliances in Rizhao city,Shandong province,and to provide references for improvement of this policy.Methods In August 2020,semi-structured interviews were conducted with 31 managers of three medical alliances in Rizhao city,regarding the objectives,specific measures,problems and influencing factors of the grid layout of the medical alliances.The grounded theory was used to sort out the interview data,along with the Mazmanian-Sabatier model for further analysis.Results The analysis resulted in 8 main categories and 19 sub-categories,including theoretical and technical support,target group characteristics,policy causality theory,current status of policy directives,inter-agency relations,socioeconomic conditions and technology,public attitudes,and media campaigns.On this basis,a theoretical framework for the implementation of the grid layout of medical alliance was formed based on the Mazmanian-Sabatier model.Conclusions The socio-economic conditions and technologies for implementing the grid-based management of medical alliances in Rizhao city were relatively mature,enjoying strong public support and good social response.But on the other hand,there were still such problems as unclear policies,imperfect mechanisms for synergy of interests among different subjects,and incomplete supporting policies.In the future,it is expected to form a policy implementation synergy,introduce supporting policies and strengthen primary teams building,in order to ensure the orderly promotion and long-term implementation of the policy.

关 键 词：医疗联合体 网格化 扎根理论 梅兹曼尼安-萨巴提尔政策执行综合模型 

分 类 号：R197.1[医药卫生—卫生事业管理]