医疗联合体异质行动者网络构建研究

医疗联合体是分级诊疗制度建立的重要部分,但在实践过程中医联体作用并未达到预期目标。本文通过查阅文献,采用行动者网络理论中的"转译"作为逻辑分析工具。通过"转译"分析区域医联体网络构建过程中遇到的障碍、参与者间的利益矛盾。研究认为,医联体涉及众多异质行动者,存在诸多矛盾和障碍,通过分析网络内各行动者的作用、利益和障碍,总结出政府的持续关注、上下级医院的协同合作以及充分利用网络技术是构建医联体并发挥作用的关键。本研究也会对政府在医联体中的正确定位,制定与优化相关医联体、分级诊疗机制和医保等政策具有参考价值。

Research of the construction of heterogeneous actor network for an integratedregional medical consortium

Aregional medical consortium is the core part in the establishment of tiered health system, but it is not successfully effective in practice. This paper examines the literature and uses the translation conceptof the actor-network theory as a logical analysis tool.Through "translating", this paper analyzes the obstacles and challenges encountered during the process of constructing regional medical association networks and the conflicts of interests among participants.The study found thatmedical consortium involves numerousheterogeneous actors, and there are many contradictions and obstacles. Continuously paying attention to medical associations, the collaboration between lower and upper hospitals and the full use of networking technology, as well as analyzing the roles, interests and obstacles of various actors in the network, are fundamental key to build a sustainable medical consortium.This study alsoprovides references for the correct positioning of the government in medical consortium, and the formulation and optimization of relevant medical associations, tiered health system and medical insurance policies.