分级诊疗视角下传染病防治体系改革的战略选择——基于一种新型SWOT-CLPV分析模型  

Strategic choice for communicable disease control and prevention under the framework of hierarchical medical system:Using a novel SWOT-CLPV Model

作　　者：王权 涂茜[4] 孙强[1,2] WANG Quan;TU Xi;SUN Qiang(Center for Health Policy and Management, School of Public Health, Shandong University, Jinan Shandong 250012, China;National Health Commission's Key Lab of Health Economics and Policy Research (Shandong University), Jinan Shandong 250012, China;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto M5T 3M6, Canada;Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100005, China)

机构地区：[1]山东大学公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]国家卫健委卫生经济与政策研究重点实验室(山东大学),山东济南250012 [3]多伦多大学卫生政策、管理与评价研究所,加拿大多伦多M5T 3M6 [4]中国医学科学院北京协和医学院,北京100005

出　　处：《中国卫生政策研究》2021年第10期17-24,共8页Chinese Journal of Health Policy

基　　金：山东大学社科新冠肺炎疫情防控研究专项。

摘　　要：通过将SWOT-CLPV模型与利益相关者理论结合,构建了一种新型战略选择分析模型。与原有的SWOT-CLPV模型相比,新模型通过各元素所涉及的利益相关的数量为各元素赋予权重,可以量化分析系统的内外挑战,同时为决策者提供基于利益相关者的多维度分析视角,提高了分析结果的科学性和可靠性。据此模型对分级诊疗视角下传染病防治体系改革进行分析,确定了与传染病分级诊疗密切相关的6个利益相关方的抑制性、杠杆效应、脆弱性以及重大问题的数量及其内涵,厘清了利益相关者们之间的相互关系和基于利益的行事逻辑。据此结果,本研究认为贯彻以病人中心的医学服务理念、完善顶层设计、明确授权并建立问责机制、贯彻强基层战略、慎用医保梯度报销政策是推进分级诊疗政策,优化传染病防治体系行之有效的战略选择。By integrating the SWOT-CLPV model and stakeholder theory,this study established a novel analysis model.Compared with the SWOT-CLPV model,the new model empowers each element with the number of relevant stakeholders,which provides the policy makers with ability of quantitative analysis and multiple analysis perspectives.By utilizing this new model,this study identified 6 stakeholders,explored their control,leverage,vulnerability and problem,and clarified the relation among them.The results show:Implement patient-centered healthcare,refine top-design,established clear empower system and accountability,reinforce primary care institutes,and be cautious with gradient reimbursement policy are feasible measures for communicable disease control and prevention reform under framework of hierarchical medical system.

关 键 词：分级诊疗 传染病防治 SWOT-CLPV分析 利益相关者 战略选择 

分 类 号：R197[医药卫生—卫生事业管理]