基于三维分析框架的我国全科医生培养政策量化研究  

Quantitative research on general practitioner policies in China based on a three-dimensional analysis framework

作　　者：祁丽 吴爽 柏海蓉 孙瑜 QI Li;WU Shuang;BAI Hairong;SUN Yu(North China University of Science and Technology,School of Economics and Management,Tangshan,Hebei 063210,China;不详)

机构地区：[1]华北理工大学经济管理学院,河北唐山063210 [2]河北医科大学公共卫生学院,河北石家庄050017

出　　处：《中华全科医学》2023年第11期1813-1817,1833,共6页Chinese Journal of General Practice

基　　金：河北省社会科学基金项目(HB22SH004)。

摘　　要：目的对我国全科医生培养政策文本进行分析,探讨全科医生培养政策存在的问题,为全科医生培养政策的完善提供借鉴和参考。方法在国务院及相关部委和机构网站上检索与全科医生培养有关的政策文件,并以政策工具视角对政策文本进行摘录和编码,基于政策工具-培养体系-政策效力的三维分析框架,运用内容分析法、PMC指数模型等研究方法,对检索出的35份全科医生培养政策进行分析。结果对35份政策文本进行编码后,共得到165个政策编码。165个政策编码中权威型、激励型、象征与劝诫型、能力建设型、系统变革型工具分别占比41.82%(69/165)、6.67%(11/165)、7.27%(12/165)、25.45%(42/165)、18.79%(31/165)。Y维度127条政策编码中,政策工具在院校教育、毕业后教育、继续教育3个阶段中使用占比分别为21.26%(27/127)、41.73%(53/127)、37.01%(47/127)。选取的4篇有代表性的全科医生培养政策PMC指数得分分别为7.401、6.201、7.334、6.001,PMC指数均值为6.734,依据PMC指数得分和政策等级,政策效力P1>P3>P2>P4,P1和P3政策效力等级为优秀,P2和P4等级为良好。结论各政策工具使用不均衡,且在3个培养阶段中的使用存在较大差异,全科医生政策效力总体处于良好水平,但存在薄弱环节。建议合理使用政策工具,加强各政策工具使用的均衡性;同时促进政策工具和培养体系的整合,提升二者协调度;提升全科医生政策的时效性、科学性和有效性。Objective To analyze the text of China's general practitioner training policy,explore the problems in the policy,and provide references and suggestions for the policy improvement.Methods Retrieve policy documents related to the general practitioner cultivation from the websites of the State Council and relevant ministries and institutions,and extract and code policy texts from the perspective of policy tools.Based on the three-dimensional analysis framework of policy tools,cultivation system,and policy effectiveness,apply research methods such as content analysis and PMC index model to analyze the 35 retrieved general practitioner cultivation policies retrieved.Results After encoding 35 policy texts,a total of 165 policy codes were obtained.Among the 165 policy codes,authoritative,motivational,symbolic and dissuasive,capacity building,and systemic transformational tools accounted for 41.82%(69/165),6.67%(11/165),7.27%(12/165),25.45%(42/165)and 18.79%(31/165),respectively.Among the 127 policy codes in the Y dimension,the proportion of policy instruments used at the three levels of institutional education,postgraduate education,and continuing education are 21.26%(27/127),41.73%(53/127),and 37.01%(47/127),respectively.The four representative general practitioner training policies selected are labeled as P1 to P4,with PMC index scores of 7.401,6.201,7.334 and 6.001,respectively.The average PMC index score of the four policy texts is 6.734.Based on the PMC index score and policy level,policy effectiveness P1>P3>P2>P4,the policy effectiveness levels P1 and P3 are excellent and the policy effectiveness levels P2 and P4 are good.Conclusion The use of different policy tools is uneven,and there are significant differences in their use across the three levels of training.The overall effectiveness of general practitioners'policies is at a good level,but there are weaknesses.Propose the rational use of policy tools and strengthen the balance of each policy tool;at the same time,promote the integration of policy tools and trai

关 键 词：全科医生培养 PMC指数 政策工具 文本挖掘 

分 类 号：R192.3[医药卫生—卫生事业管理] R499[医药卫生—公共卫生与预防医学]