北京市分级诊疗政策文本量化研究——基于政策工具、政策扩散和政策目标的三维框架  

Quantitative Study on the Text of Graded Diagnosis and Treatment Policy in Beijing——A Three-dimensional Framework based on Policy Instruments,Policy Diffusion,and Policy Objectives

作　　者：邓剑伟[1] 隋成城 武渲杰 邵雨菲 张鹏[1] DENG Jianwei;SUI Chengcheng;WU Xuanjie;SHAO Yufei;ZHANG Peng(School of Management,Beijing Institute of Technology,Beijing 100081,China)

机构地区：[1]北京理工大学管理学院,北京100081

出　　处：《北京理工大学学报(社会科学版)》2025年第2期162-174,共13页Journal of Beijing Institute of Technology:Social Sciences Edition

基　　金：北京市社会科学基金重点项目“数据驱动的北京分级诊疗政策执行的行为机制与效果评价研究”(22GLA009)。

摘　　要：通过互联网检索北京市政府及各区级政府发布的分级诊疗政策文本,建立政策工具、政策扩散、政策目标的三维框架,运用内容分析法开展研究。共纳入100份政策文本,三类七种政策工具呈现:环境型工具(42.28%)与供给型工具(39.71%)共同引导,需求型工具相对欠缺(18.01%)的差异化使用格局;政策扩散层面:市级由上至下全面推广(92.27%)主导作用明显,市级对区级授权试验(2.76%)和区级先行探索自下而上(4.42%)绝对欠缺。政策目标相对多元化,集中于完善医疗卫生服务体系(53.14%),优化医疗资源均衡分布(21.70%)。建议加强需求型工具的运用,同时提升环境型政策工具内部的均衡情况,深化区级政府的参与程度,重点提升其创新能动力。在此基础上,进一步推动政策目标的多元化,促进政策工具、政策扩散、政策目标的多维耦合,进一步建设惠民、利民的分级诊疗体系。The texts of graded diagnosis and treatment policy issued by Beijing municipal government and district governments were searched through the Internet,and a three-dimensional framework of policy tools,policy diffusion and policy objectives was established.A total of 100 policy texts were included in this paper,and 7 policy tools of 3 categories showed a differentiated use pattern of environmental tools(42.28%)and supply tools(39.71%)co-guided,while demand-based tools were relatively lacking(18.01%).At the level of policy diffusion,the leading role of municipal comprehensive promotion from top to bottom(92.27%)is obvious,and the municipal authorization experiment at district level(2.76%)and the bottom-up exploration at district level(4.42%)are absolutely lacking.Policy objectives are relatively diversified,focusing on improving the medical and health service system(53.14%)and optimizing the balanced distribution of medical resources(21.70%).It is suggested to strengthen the use of demand-based tools,improve the internal balance of environment-based policy tools,deepen the participation of district-level governments,and focus on improving their innovation power.On this basis,it is important to further promote the diversification of policy objectives,promote the multidimensional coupling of policy tools,policy diffusion,and policy objectives,and further build a hierarchical diagnosis and treatment system that benefits the people.

关 键 词：分级诊疗 文本分析 政策工具 政策目标 政策扩散 

分 类 号：R19[医药卫生—卫生事业管理]