数字技术嵌入、基层卫生组织韧性提升与服务体系重塑:作用机制与行动框架  

Digital technologies embedding,enhancing organizational resilience and reshaping service system in primary healthcare:Mechanism and action framework

作　　者：李忠[1,2] 张亮[3] 李浩淼[3] 崔兆涵 陈鸣声 LI Zhong;ZHANG Liang;LI Hao-miao;CUI Zhao-han;CHEN Ming-sheng(School of Health Policy and Management,Nanjing Medical University,Nanjing Jiangsu 211166,China;Laboratory for Digital Intelligence&Health Governance,Nanjing Medical University,Nanjing Jiangsu 211166,China;School of Political Science and Public Administration,Wuhan University,Wuhan Hubei 430072,China)

机构地区：[1]南京医科大学医政学院,江苏南京211166 [2]南京医科大学数智技术与健康治理实验室,江苏南京211166 [3]武汉大学政治与公共管理学院,湖北武汉430072

出　　处：《中国卫生政策研究》2024年第9期36-43,共8页Chinese Journal of Health Policy

基　　金：教育部人文社会科学研究青年基金(23YJCZH114);江苏省高校哲学社会科学研究基金一般项目(2022SJYB0299);国家自然科学基金面上项目(71874086)。

摘　　要：本文基于“结构—过程—结局—制度”框架,辨析了基层卫生韧性的概念内涵和表现形态。阐明了数字技术嵌入提升基层医疗卫生机构组织韧性的作用机制,并构建了韧性视角下数字技术重塑基层卫生服务体系的行动框架。研究发现:(1)组织韧性是基层卫生韧性的核心。(2)数字技术主要通过促进变化感知、知识吸收和知识整合推动资源组织耦合,提升基层医疗卫生机构组织韧性。(3)组织韧性提升与服务体系重塑间呈双向互动关系。(4)应统一工具理性、制度理性和价值理性以确立数字技术重塑基层卫生服务体系的嵌入、治理和评价框架,推动基层卫生服务能力提升、政策优化和价值共创。Using the“structure-process-outcome-institution”framework,this article analyzes the conceptual connotation and manifestation of primary care resilience.The mechanism by which digital technologies embedding improve organizational resilience of primary healthcare institution was elucidated;From the resilience perspective,an action framework for reshaping the primary healthcare system by digital technologies was constructed.Research has found that:1)Organizational resilience is the core of primary healthcare resilience.2)Digital technologies mainly promote coupling coordination between resource and organization through promoting change perception,knowledge absorption,and knowledge integration,improve organizational resilience of primary healthcare institution.3)There is a bidirectional interaction between the improvement of organizational resilience and reshaping primary healthcare system;4)The relevant departments should unify instrumental rationality,institutional rationality,and value rationality to establish the embedding,governance,and evaluation framework for digital technologies to reshape the primary healthcare system.

关 键 词：基层卫生 组织韧性 服务体系 数字技术 行动框架 

分 类 号：R197[医药卫生—卫生事业管理]