政策工具视角下我国远程医疗国家层面政策分析(1997—2019)

目的:远程医疗是现代医学发展的重要方向之一,其健康发展有赖于政府政策的驱动,掌握远程医疗政策工具的供给结构是理解、评估和改善我国远程医疗发展的最佳途径。方法:从政策工具视角出发,基于"政策工具类型维度"和"政策工具目标价值维度",采用内容分析法对我国1997—2019年发布的222份国家层面的远程医疗相关政策文件进行统计分析。结果与结论:(1)从政策工具类型维度来看,我国远程医疗供给侧政策工具过溢,内部结构不均衡,需求侧政策工具应用不足,环境侧政策工具内部组合不协调,政策总体呈现以政府为主导的投入推动特征。个别政策工具如教育培训、公私合作、政策宣传等应用较少,医保支付政策工具也还需进一步完善。(2)从政策工具目标价值维度来看,政策工具在各阶段都存在明显的差异化选择特征,较少着眼于远程医疗产业整体良性循环的实现,不能够在规范和指导医疗机构间远程医疗平台建设的同时实现远程医疗产业的整体发展与质的提升。

Analysis of China's telemedicine policy from the perspective of policy tools: A research based on the national policy texts

Objective: Telemedicine is one of the most important directions in the domain of modern medicine development. Its steadfast development depends on the way the government implements policies. Mastering the structure of telemedicine policy tools is the best way to understand, evaluate and enhance the development of telemedicine in China. Methods: From the perspective of policy tools and based on the "type dimension" and "target value dimension", 222 national telemedicine policy documents released in China during the period from 1997 to 2019 were analyzed by content analysis. Results and conclusions:(1) From the perspective of the type of policy tools, the China''s telemedicine supply side policy tools have overflowed, the internal structure is unbalanced, the demand side policy tools are insufficiently applied, the environmental side policy tools are not coordinated internally, and the overall policy presents the characteristics of government-led investment promotion. Some individual policy tools such as education and training, commune cooperation, policy awareness, etc., are rarely used, and medical insurance payment policy tools need to be further improved. (2) From the perspective of target value of the policy tools, there are obvious differences in the policy tools at all stages of the selection process. Obviously, there is less focus on the realization of overall virtuous circle of the telemedicine industry and it''s hard to standardize and guide the telemedicine system among medical institutions. At the same time, the overall development and quality of telemedicine industry need to be improved.