政策工具视角下我国县域医共体政策文本分析

目的 对我国县域医共体建设相关政策进行分析，探讨其侧重点及不足之处，以期为我国县域医共体建设提供参考。方法 以政策工具方法为理论指导，制定政策分析二维框架，研究对象为2017年1月-2022年3月我国政府层面发布的县域医共体相关政策，对符合纳入条件的政策文本进行编码、分类和统计分析。结果 X政策工具维度共有100条编码，分类后供给型、环境型、需求型工具分别为34个、64个、2个。Y系统论维度共有100条编码，分类后内部子模指标59个，外部子模指标41个。结论 政策工具的推动及拉动作用未发挥最佳功效；子工具应用结构不合理，使用不充分；政策未能适时动态调整，忽视地区情况的差异性；内外部子模差异较大，技术、经济和社会系统使用较少。应多元化使用政策工具，优化组合政策工具使用与结构，动态化使用政策，优化系统内外部工具比例。

Policy Text Analysis of County Medical Community in China from the Perspective of Policy Tools

ObjectiveTo analyze the policies related to the construction of county medical community in China, and discuss their emphases and shortcomings, in order to provide reference for the construction of county medical community in China.MethodsBased on the theoretical guidance of policy tools and methods, a two-dimensional framework for policy analysis was developed. The research object was the relevant policies of county medical communities published by the Chinese government from January 2017 to March 2022. The policy texts eligible for inclusion were coded, classified and statistically analyzed. ResultsThere were 100 codes in X policy tool dimension, and there were 34, 64 and 2 for supply, environment and demand tools, respectively. There were 100 codes in the dimension of Y system theory. After classification, there were 59 internal sub-model indexes and 41 external sub-model indexes.Conclusion The promotion and pulling function of policy tools did not play the best effect. The application structure of sub-tools was not reasonable and the use was not sufficient. The policy failed to adjust dynamically timely and ignored the different regional conditions. The internal and external sub-models differed greatly, and the technical, economic and social systems were less used. The policy should be diversified, the combination and structure of policy tools should be improved, the policy should be dynamically used, and the proportion of tools inside and outside the system should be optimized.