我国省级层面县域医共体政策注意力演变研究  

Study on the evolution of policy attention to county-level medical communities at the provincial level in China

作　　者：谭浩 王力[1] 王军永[1] 刘霞[1] 梅杰 周佳佳 刘雨璇 余苏珍 TAN Hao;WANG Li;WANG Junyong;LIU Xia;MEI Jie;ZHOU Jiajia;LIU Yuxuan;YU Suzhen(Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi Province,330004,PRC)

机构地区：[1]江西中医药大学,江西省南昌市330004 [2]南昌工学院,江西省南昌市330108

出　　处：《中国医院》2025年第1期9-15,共7页Chinese Hospitals

基　　金：国家自然科学基金(72064023,71764012);江西省高校人文社会科学重点研究基地项目(JD20077)。

摘　　要：目的:分析省级县域医共体政策注意力演变过程与规律,以期为后续政策的制定与优化提供参考。方法:将省级县域医共体政策划分为探索期和试点期两个阶段,以及东部、中部、西部3个地区,以政策注意力理论为指导,分析各阶段、各地区的县域医共体政策注意力强度与政策注意力配置,并运用PMC指数模型对不同阶段、不同地区的县域医共体政策文本进行政策注意力综合量化评价。结果:省级县域医共体政策注意力存在时空差异。在时间维度表现为省级政策以中央政策为导向,试点期政策注意力强度大于探索期,政策注意力配置随中央政策注意力的侧重而转移;在空间维度上,省级县域医共体政策注意力水平地域差异性较大,东部省份较高,中部地区次之,西部地区较低。结论:省级县域医共体政策出台一方面要坚持中央导向与地方创新的统一,既要在中央政策的指导下进行政策制定,又要根据地域实际情况进行区域特征性政策创新;另一方面要坚持顶层支持与区域合作的统一,既需要由中央对县域医共体政策注意力水平较低的地区进行垂直的专项支持,又要发挥近邻效应与示范效应的作用进行区域间的平行合作,以提升县域医共体政策水平。Objective:To analyze the evolution and patterns of policy attention to county-level medical communities at the provincial level,providing references for the formulation and optimization of future policies.Methods:Provincial-level county medical community policies were divided into two phases:the exploration period and the pilot period,as well as three regions:eastern,central,and western.Guided by the theory of policy attention,the study analyzed the intensity and allocation of policy attention across different phases and regions.Additionally,the PMC index model was employed to conduct a comprehensive quantitative evaluation of policy attention in policy texts across different phases and regions.Results:The study revealed spatiotemporal differences in policy attention to county-level medical communities at the provincial level.Temporally,provincial policies followed central policy guidance,with stronger policy attention during the pilot period than the exploration period.The allocation of policy attention shifted in response to the focus of central policy attention.Spatially,policy attention levels varied significantly across regions,with higher levels in eastern provinces,moderate levels in central regions,and lower levels in western regions.Conclusion:The formulation of provincial county-level medical community policies should balance central guidance and local innovation,ensuring alignment with central policies while innovating based on regional characteristics.Furthermore,top-down support and regional collaboration should be unified:central authorities should provide targeted support to areas with lower policy attention,while leveraging neighboring and demonstrative effects to enhance inter-regional cooperation and elevate the overall level of county-level medical community policies.

关 键 词：县域医共体 政策注意力 熵值法 社会网络分析 PMC指数模型 

分 类 号：R197[医药卫生—卫生事业管理]