多源流理论视角下县域医共体政策变迁的动力分析——以安徽省天长市为例  

Dynamic analysis on policy changes of county medical alliance under the perspective of multiple-streams theory——Take Tianchang city of Anhui Province as an example

作　　者：孙杨 代涛[3] 郑英[3] 李力[3] 胡佳 SUN Yang;DAI Tao;ZHENG Ying;LI Li;HU Jia(Peking Union Medical College,Beijing 100730,China;Institute of Medical Information Research Institute of Chinese Academy of Medical Sciences,Beijing 100020,China;Center for Health Policy and Management of Chinese Academy of Medical Sciences,Beijing 100020,China)

机构地区：[1]北京协和医学院,北京100730 [2]中国医学科学院医学信息研究所,北京100020 [3]中国医学科学院卫生政策与管理研究中心,北京100020

出　　处：《卫生软科学》2022年第4期11-16,共6页Soft Science of Health

基　　金：中国医学科学院医学与健康科技创新工程项目-医学科技创新评价与卫生服务体系构建研究(2016-I2M-3-018)。

摘　　要：基于多源流理论,以安徽省天长市县域医共体为例,探讨了我国地方层面县域医共体政策变迁的动力。研究发现,上级政策的要求以及地方问题的变化,打开了地方层面县域医共体以政治或问题为主导的政策之窗,结合可行的政策方案,在改革者的推动下,促进政治、问题、政策三条源流有效汇合,实现政策变迁。其中,上级政策变化对地方层面县域医共体政策变迁具有决定和促进作用,不同层级之间政策窗口的相互配合也至关重要,有助于推动政策变迁并实现政策创新与扩散,为全国其他地区县域医共体建设提供一定参考与借鉴。Based on multiple-streams theory,this paper takes county medical alliance in Tianchang city of Anhui Province as an example.It discusses the driving forces of policy changes of county medical alliance at local level in China.The results show that the policy window oriented by policy or problems in county medical alliance at local level is opened since of the requirements of superior policy and the change of local problems change.Combine with the feasible policy plan,it can promote the effective convergence of the three sources of politics,problems and policy at the urging of reformers,so as to realize the policy change.The change of higher-up policy plays a decisive and promoting role in the policy change of county medical alliance at the local level,and the coordination of policy windows at different levels is also crucial,which helps to promote policy change and achieve policy innovation and diffusion,and provides some reference for the construction of county medical alliance in rest of the country.

关 键 词：多源流理论 县域医共体 政策变迁 动力模式 

分 类 号：R197.3[医药卫生—卫生事业管理] R197.4[医药卫生—公共卫生与预防医学]