高质量发展背景下基于PEST-SWOT模型的三级公立医院学科建设策略研究  

Researches on Discipline Construction Strategy in Tertiary Public Hospitals Based on PEST-SWOT Model in the Context of High-Quality Development

作　　者：李安琪 伊永菊[1,2] 白城铭 周炜良 陈舒妤 方乐堃 Li Anqi(The Sixth Affiliated Hospital Sun Yat-sen University,Guangzhou,P.R.China)

机构地区：[1]中山大学附属第六医院,广东广州510655 [2]广州市黄埔区中六生物医学创新研究院

出　　处：《中国卫生事业管理》2024年第8期923-927,共5页Chinese Health Service Management

基　　金：国家优秀青年科学基金“结直肠癌发生发展机制研究”(82222056);卫生部国家临床重点专科建设基金“2012年国家临床重点专科建设项目”([2012]649);广东省科技计划学科类重点实验室评估专项“广东省结直肠盆底疾病研究重点实验室”(2023B1212060017);广东省科技计划协同创新与平台环境建设专项“广东省消化系统疾病临床医学研究中心”(2020B1111170004)。

摘　　要：目的:在高质量发展背景下,分析我国三级公立医院学科建设现状与策略,为探索学科高质量发展路径和模式提供参考。方法:通过对2016年以来的17份相关政策文件解读及2019年以来的148篇相关文献分析,基于PEST-SWOT模型,从政治、经济、社会和技术四个维度对三级公立医院学科建设内部优劣势与外部机遇和威胁进行梳理总结。结果:在内部优势方面,三级公立医院社会知名度和患者信任度高、地理位置优越、诊治能力全面、学科特色性强,党建、文化和制度引领赋能学科建设。在内部劣势方面,公立医院盈利能力及医疗资源受限、规模与效益发生冲突、学科发展不均衡、人才引育困难且医教研负担较重。在外部机遇方面,三级公立医院学科建设发展符合国家战略发展需要,我国基本医疗覆盖面大、居民高水平医疗服务需求提升,医保支付方式的改革和紧密型医联体趋势有效推动医疗资源上下贯通,信息技术迭代升级也实现了医疗服务效率和质量的提升。在外部威胁方面,国家经济增长放缓、医疗政策落实相对滞后且监管机制亟需完善、医保异地结算不便、患者机会主义行为与DRG目标发生冲突、公众疾病防治素质差异大及健康理念亟待转变制约着学科发展。结论:政策的支持,社会、经济和技术的发展为三级公立医院学科建设带来了新的机遇和挑战,未来应根据自身学科发展的优劣势,相应采取增长型、扭转型、建设型和防御型发展战略,实现学科高质量内涵式发展。Objective To analyze the current situation and strategy of discipline construction in Chinas tertiary public hospitals in the context of high-quality development,and provide a reference for exploring the modes of high-quality development of dis-ciplines.Methods Through the analysis of 17 policy documents since 2016 and 148 related literatures since 2019,the internal ad-vantages and disadvantages,external opportunities and threats were summarized from four dimensions of politics,economy,society and technology based on the PEST-SWOT model.Results In terms of internal advantages,there had high social awareness,high degree of patients'trust,favorable location,comprehensive treatment capabilities and characterized discipline construction in ter-tiary public hospitals.For internal disadvantages,there had limited medical resources,conflict between scale and efficiency,une-ven development of disciplines,difficulty in attracting and nurturing talents,and heavy burden of medicine,education and re-search in tertiary public hospitals.In terms of external opportunities,the discipline construction of tertiary public hospitals was in line with the national strategic development needs.In terms of external threats,the discipline development was constrained by the slowdown of national economic growth,the relative lag in the implementation of policies,the inconvenience of medical insurance settlement,the conflict between patients'opportunistic behaviors and the goals of DRG,and the urgent need for a change in the concept of health.Conclusion The policies'support,and the development of society,economy and technology have brought new opportunity and challenges for the discipline construction in tertiary public hospitals.It is suggested to adopt growth,reversal,construction and defensive development strategies to achieve the high-quality development.

关 键 词：高质量发展 PEST-SWOT模型 三级公立医院 学科建设 

分 类 号：R197.3[医药卫生—卫生事业管理]