我国公立医院高质量发展政策三维框架分析  

A Three-Dimensional Framework Analysis of High-Quality Development Policies for Public Hospitals in China

作　　者：宫云娜 王文超 隋欣 宋立芹 菅云龙 鲜国炜 马勇 Gong Yunna;Wang Wenchao;Sui Xin(School of Management,Shandong Second Medical University,Weifang,Shandong,261053,China;不详)

机构地区：[1]山东第二医科大学管理学院,山东潍坊261053

出　　处：《中国医院管理》2025年第5期27-32,共6页Chinese Hospital Management

基　　金：国家社会科学基金项目(20CFX017);教育部人文社会科学研究一般项目(21YJC820050)。

摘　　要：目的探讨我国公立医院高质量发展政策的特点、潜在挑战及优化路径,为政策制定和实施提供参考。方法运用Nvivo 11软件对2021—2024年中央及省级层面发布的31份公立医院高质量发展政策文本进行内容编码,基于政策工具、利益相关者和系统维度构建三维分析框架,结合定量与定性方法进行内容分析。结果研究发现,3个维度的政策内容分布呈现阶段性不均衡特征:政策工具以环境型为主,供给型次之,需求型最少;利益相关者关注集中于公立医院和医疗卫生行政部门,患者关注度较低;系统维度主要聚焦于宏观层面,中观和微观层次分布较少。虽然政策工具分布的不均衡在特定阶段具有针对性,但长期的结构性失衡可能导致政策系统性不足和利益相关者协同弱化,急需优化工具结构。结论建议在政策设计中提升需求型政策工具比例,动态调整3类工具的协同应用;加强对患者等弱势利益相关者的关注;优化中观与微观层面的政策设计,以提升政策实施的系统性和可持续性。Objective To explore the characteristics,potential challenges,and optimization paths of high-quality development policies for public hospitals in China,and to provide reference for policy formulation and implementation.Methods The 31 policy documents on high-quality development of public hospitals issued at the central and provincial levels between 2021 and 2024 were coded using Nvivo 11 software,and a three-dimensional analytical framework was constructed on the basis of the policy tools,stakeholders,and system dimensions,combining both quantitative and qualitative methods for content analysis.Results It found that the distribution of policy content in the three dimensions was characterized by stage imbalance:policy tools were mainly environmental,followed by supply,and demand;stakeholder attention was focused on public hospitals and healthcare administrations,and patient attention was low;The system dimension focused mainly on the macro level,with less distribution at the meso and micro levels.Although the unbalanced distribution of policy instruments is relevant at certain stages,the long-term structural imbalance may lead to insufficient systemic policies and weakened stakeholder synergies,and there is an urgent need to optimize the structure of instruments.Conclusions It is recommended to increase the proportion of demand-based policy instruments in policy design and dynamically adjust the synergistic application of the three types of instruments;to strengthen the attention to vulnerable stakeholders,such as patients;and to optimize the design of policies at the meso-levels and micro-levels in order to enhance the systemicity and sustainability of policy implementation.

关 键 词：公立医院 高质量发展 三维分析框架 

分 类 号：R19-0[医药卫生—卫生事业管理]