分级诊疗政策叙事的概念重构:三重理解与内涵辨析  

The Concept’s Reconstruction on Policy Narratives of Hierarchical Diagnosis:Three Domain of Understanding and Connotation Interpretation

作　　者：王鸿妮 赵鑫[1] 纪科宇 常潇 程偲宇 张淑娥[2] 张敏 赵晓雯[2] 孙涛 Wang Hongni;Zhao Xin;Ji Keyu;Sun Tao(Department of Health Management,Hangzhou Normal University,Hangzhou,Zhejiang,311121,China;不详)

机构地区：[1]杭州师范大学医学部卫生管理与政策系,浙江杭州311121 [2]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150081 [3]北京大学深圳医院,广东深圳518036

出　　处：《中国医院管理》2022年第4期5-8,12,共5页Chinese Hospital Management

基　　金：国家自然科学基金项目(71774045);杭州师范大学科研启动经费项目(2019QDL038)。

摘　　要：分级诊疗作为我国卫生政策领域的重要议题,是一种被广泛关注和被高频叙事本土化政策实践。现实中,分级诊疗政策叙事中存在表达不清和语言错用的现象,阻碍了人们对分级诊疗实践的充分理解,也限制了国家动员和引领改革的集体行动。基于此,提出分级诊疗的愿景观、体系观以及制度观三重平行概念,试图重新梳理和区分对分级诊疗政策叙事的认知图景。此外,采用新的语言风格对分级诊疗政策叙事进行全新厘清与阐释,旨在借用复杂科学和生态话语的语言及语料,完善分级诊疗政策叙事的概念要件与话语系统。As an important issue in the field of local health policy in China,hierarchical healthcare is a highly narrated and widely concerned policy practice.In reality,there are problems of unclear expression and misuse of language in the narrative of tiered medical services policy,which hinder understanding of the practice of hierarchical healthcare,and also limit the collective action in the process of mobilizing and leading the reform.It puts forward the three parallel concepts of“willing landscape”,“system view”and“system view”of tiered medical services,trying to resort out and distinguish the cognitive picture of tiered medical services policy narrative.It uses a new language style to clarify and explain the narrative of hierarchical healthcare policy.The purpose is to reconstruct the conceptual elements and discourse system of hierarchical healthcare policy narrative by using the language and logic of complex and ecological discourse.

关 键 词：分级诊疗 政策叙事 愿景观 体系观 制度观 

分 类 号：R197.3[医药卫生—卫生事业管理]