整合型医疗健康服务体系理论框架的核心要素与演变特点——基于系统综述  

Core elements and development characteristics of the theoretical framework of integrated healthcare system:A systematic review

作　　者：胡佳[1] 郑英[1] 代涛[1] 王清波[2] 李力[1] HU Jia;ZHENG Ying;DAI Tao;WANG Qing-bo;LI Li(Center for Health Policy and Management,Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China;School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]中国医学科学院医学信息研究所卫生政策与管理研究中心,北京100020 [2]北京大学公共卫生学院,北京100191

出　　处：《中国卫生政策研究》2022年第1期11-19,共9页Chinese Journal of Health Policy

基　　金：中国医学科学院医学与健康科技创新工程经费资助项目(CIFMS 2016-I2M-3-018)。

摘　　要：目的:归纳总结国内外整合型医疗健康服务体系理论框架的基本特征、主要维度及核心要素,分析演变特点及启示。方法:采用系统综述法检索并筛选文献,依据前期研究提出的制度整合、组织整合、专业整合、服务整合、核心功能整合、价值规范整合6个维度,利用主题框架法提取和分析文献资料。结果:纳入分析的66个理论框架中,12个聚焦单一维度、45个涉及2~5个维度、9个涵盖全部6个维度;制度整合、组织整合、专业整合、服务整合、核心功能整合、价值规范整合分别包含7个、6个、5个、7个、4个以及2个核心要素。讨论与建议:理论框架演变趋势呈现对"以人为中心"理念的重视程度日益加深,维度逐渐多元、覆盖层次逐渐全面,对服务内涵的界定向综合性健康服务转变,对体系的认识向动态适应转变等特点;我国应充分借鉴参考,构建和完善符合国情和发展阶段的整合型医疗健康服务体系理论框架。Objective:To summarize the basic features,main dimensions and core elements of domestic and foreign theoretical frameworks of integrated healthcare system,and to analyze their development characteristics and inspirations.Methods:Systematic review method was used to retrieve and screen the literature.Thematic framework method was adopted to extract,integrate and analyze the literature’s materials based on the 6 dimensions proposed in our previous research including system integration,organizational integration,professional integration,care integration,core functional integration,value and normative integration.Results:Among the 66 theoretical frameworks included in the analysis,12 were focused on a single dimension,45 involved 2~5 dimensions,and 9 covered all 6 dimensions.The dimension of system integration,organizational integration,professional integration,care integration,core functional integration,value and normative integration respectively contained 7,6,5,7,4 and 2 core elements.Discussions and suggestions:The development of the theoretical frameworks manifested a gradual trend of increasing emphasis on the concept of“people-centered”and dimension diversification as well as comprehensiveness of coverage levels,and were also featured by the transformation of the essential definition of service towards comprehensive health services,and the transformation of the understanding of healthcare system towards dynamically adaptive.Our nation should effectively learn from these results,so as to construct and improve the theoretical framework of our integrated healthcare system in accordance with the current national conditions and development stage of China.

关 键 词：以人为中心 整合型医疗健康服务体系 理论框架 系统综述 

分 类 号：R197[医药卫生—卫生事业管理]