ISSN 1008-2204
CN 11-3979/C

新医改十年:中国医疗卫生信息化多元政策主体协同治理研究

Ten Years of New Medical Reform: Collaborative Governance of Multiple Policy Subjects of Medical and Healthcare Informatization in China

  • 摘要: 医疗卫生信息化建设既是中国新一轮医疗卫生体制改革的建设重点,也是实现中国医疗卫生治理现代化的技术基础,但医疗卫生信息化建设内容系统、复杂,需要多部门高效合作、协同治理。基于新医改十年以来国家层面颁布的医疗卫生信息化政策文本,利用社会网络分析方法测度政策制定主体合作网络节点属性,构建政策主体合作“广度—深度”的二维矩阵,分析医疗卫生信息化建设中不同政策主体协同治理的角色演变规律。研究表明,医疗卫生信息化建设的政策主体日益多元,主体间协作关系日益复杂,但发挥其核心作用的机构有限,政策协作网络中心化特征显著;国家卫健委、国家中医药管理局、国家发改委、财政部、科技部、工信部、民政部、国家市场监督管理总局、教育部之间逐渐形成紧密合作闭环;政策主体角色变迁路径以渐进式演进为主,而突进式演进的直接动力主要源于上级政府关键政策文本的颁布。政策导向的学习与交流机制,是构建基于信任的府际关系、促进政策主体协同和实现医疗卫生治理现代化的重要前提。

     

    Abstract: The construction of medical and healthcare informatization is the focus of the new round of medical and healthcare system reform in China, and is also the technical basis to realize the modernization of medical and healthcare governance in China. However, the construction of medical and healthcare informatization is systematic and complex, which requires efficient cooperation and collaborative governance of multiple sectors. Based on the relevant documents issued at the national level since the new medical and healthcare reform ten years ago, the paper uses social network analysis to measure the node attributes of the collaboration network of policy subjects, and builds a two-dimensional matrix of the “breadth-depth” of the collaboration among policy subjects to analyze the evolution rules of the roles of different policy subjects in the collaborative governance of the construction of medical and healthcare informatization. The results show that the policy subjects are becoming increasingly diversified, and the collaborative relationship between subjects is increasingly complex, but the institutions that play the core role are limited, and the policy collaborative network is remarkably centralized. A closed loop of close collaboration has gradually been formed among the National Health Commission, the National Administration of Traditional Chinese Medicine, the National Development and Reform Commission, the Ministry of Finance, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the Ministry of Civil Affairs, the State Administration for Market Regulation, and the Ministry of Education. The change path of the roles of the policy subjects is mainly progressive, and the direct driving force for sudden evolution stems primarily from the promulgation of the key policy texts by the higher-level governments. Policy-oriented mechanism for learning and communication is an important prerequisite for building trust-based intergovernmental relations, promoting the collaboration among policy subjects, and realizing the modernization of medical and healthcare governance.

     

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