Article(id=1240395013838926822, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240395006914130733, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202503288, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1741881600000, receivedDateStr=2025-03-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773662816724, onlineDateStr=2026-03-16, pubDate=1753372800000, pubDateStr=2025-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773662816724, onlineIssueDateStr=2026-03-16, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773662816724, creator=13701087609, updateTime=1773662816724, updator=13701087609, issue=Issue{id=1240395006914130733, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1773662815073, creator=13701087609, updateTime=1773662858015, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1240395187109810535, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240395006914130733, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1240395187109810536, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1240395006914130733, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2588, endPage=2593, ext={EN=ArticleExt(id=1240395014166081541, articleId=1240395013838926822, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=An analysis of policy texts on healthcare system development from the perspective of policy instruments, Jiangsu, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the characteristics and issues of Jiangsu’s healthcare system policies and provide optimization insights.

Methods

Using Rothwell and Zegveld’s policy tool classification, a three-dimensional framework (policy tools, development process, policy goals) was constructed to quantify 70 policy texts from the 13th and 14th Five-Year Plan periods.

Results

Policy tools: environmental-type dominated (58.83%), followed by supply-type (34.78%), demand-type (6.38%) was minimal. Policy process: implementation (52.27%) and planning (40.24%) prevailed, while supervision (6.48%) and evaluation (1.02%) were underdeveloped. Policy goals: advancing public hospital quality (44.11%) was prioritized, whereas strengthening medical insurance (9.03%) lagged.

Conclusion

Structural imbalance in policy tools, fragmented policy processes, and divergent goals were observed. Recommendations: optimize tool allocation by increasing demand-type tools, integrate policy processes, and align goals systematically.

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目的

分析总结江苏省医疗体系建设政策的构成特点与问题,为江苏医疗体系建设的优化与完善提供借鉴。

方法

采用Rothwell和Zegveld政策工具分类方法,构建政策工具—政策发展过程—政策目标三维分析框架,对十三五及十四五期间发布的70份政策文本进行量化分析。

结果

政策工具维度下以环境型(58.83%)为主,其次是供给型(34.78%),需求型(6.38%)最少。政策发展过程维度以政策实施(52.27%)和政策规划(40.24%)为主,政策监督(6.48%)及政策评价(1.02%)占比则较小。政策目标维度加快公立医院高质量发展(44.11%)最多而强化医保政策支撑(9.03%)最少。

结论

政策工具结构不均衡,政策过程结果呈现离散状态,政策目标建设重点分化。建议适度增加需求型工具的使用,优化政策工具结构,统筹规划政策发展过程和政策目标建设。

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徐佩,E-mail:
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王飞(2001—),男,硕士在读,研究方向:卫生政策与管理

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Quantitative analysis of China’s Traditional Chinese Medicine health service policy based on the perspective of policy tools[J]. Modern Preventive Medicine, 2021, 48(23): 4299-4303. (In Chinese), articleTitle=Quantitative analysis of China’s Traditional Chinese Medicine health service policy based on the perspective of policy tools, refAbstract=null), Reference(id=1240413546006246215, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, doi=null, pmid=null, pmcid=null, year=2019, volume=22, issue=10, pageStart=1139, pageEnd=1146, url=null, language=null, rfNumber=[10], rfOrder=17, authorNames=张招椿, 胡海源, 陈川, journalName=中国全科医学, refType=null, unstructuredReference=张招椿,胡海源,陈川,等.政策工具视角下我国家庭医生政策量化分析[J].中国全科医学2019,22(10):1139-1146., articleTitle=政策工具视角下我国家庭医生政策量化分析, refAbstract=null), Reference(id=1240413546132075345, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, doi=null, pmid=null, pmcid=null, year=2019, volume=22, issue=10, pageStart=1139, pageEnd=1146, url=null, language=null, rfNumber=[10], rfOrder=18, authorNames=Zhang ZC, Hu HY, Chen C, journalName=Chinese General Practice, refType=null, unstructuredReference=Zhang ZC, Hu HY, Chen C, et al. Quantitative analysis of family doctor policies in China from the perspective of policy tools[J]. Chinese General Practice, 2019, 22(10): 1139-1146. (In Chinese), articleTitle=Quantitative analysis of family doctor policies in China from the perspective of policy tools, refAbstract=null), Reference(id=1240413546253710167, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, doi=null, pmid=null, pmcid=null, year=2021, volume=38, issue=6, pageStart=440, pageEnd=443, 449, url=null, language=null, rfNumber=[11], rfOrder=19, authorNames=李翠, 尹文强, 孙艳, journalName=中国卫生事业管理, refType=null, unstructuredReference=李翠,尹文强,孙艳,等.政策工具视角下乡村医生相关政策文本分析[J].中国卫生事业管理2021,38(6):440-443, 449., articleTitle=政策工具视角下乡村医生相关政策文本分析, refAbstract=null), Reference(id=1240413546387927902, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, doi=null, pmid=null, pmcid=null, year=2021, volume=38, issue=6, pageStart=440, pageEnd=443, 449, url=null, language=null, rfNumber=[11], rfOrder=20, authorNames=Li CY, Yin WQ, Sun Y, journalName=Chinese Health Service Management, refType=null, unstructuredReference=Li CY, Yin WQ, Sun Y, et al. Text analysis of rural doctors’ relative policies from the perspective of policy tools[J]. Chinese Health Service Management, 2021, 38(6): 440-443, 449. (In Chinese), articleTitle=Text analysis of rural doctors’ relative policies from the perspective of policy tools, refAbstract=null), Reference(id=1240413546509562724, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, doi=null, pmid=null, pmcid=null, year=2021, volume=14, issue=10, pageStart=25, pageEnd=30, url=null, language=null, rfNumber=[12], rfOrder=21, authorNames=余秋静, 曹娜, 陈宗顺, journalName=中国卫生政策研究, refType=null, unstructuredReference=余秋静,曹娜,陈宗顺,等.政策工具视角下我国省级层面健康规划政策文本量化分析[J].中国卫生政策研究2021,14(10):25-30., articleTitle=政策工具视角下我国省级层面健康规划政策文本量化分析, refAbstract=null), Reference(id=1240413546656363371, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, doi=null, pmid=null, pmcid=null, year=2021, volume=14, issue=10, pageStart=25, pageEnd=30, url=null, language=null, rfNumber=[12], rfOrder=22, authorNames=Yu QJ, Cao N, Chen ZS, journalName=Chinese Journal of Health Policy, refType=null, unstructuredReference=Yu QJ, Cao N,Chen ZS, et al. Quantitative analysis of China’s health planning policy texts at the provincial level from the perspective of policy tools[J]. Chinese Journal of Health Policy, 2021, 14(10): 25-30. (In Chinese), articleTitle=Quantitative analysis of China’s health planning policy texts at the provincial level from the perspective of policy tools, refAbstract=null)], funds=[Fund(id=1240413541698695831, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, awardId=23YJA630106, language=CN, fundingSource=教育部人文社会科学研究规划基金项目(23YJA630106), fundOrder=null, country=null), Fund(id=1240413541828719262, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, awardId=23JZB007, language=CN, fundingSource=江苏省社会科学基金项目(23JZB007), fundOrder=null, country=null), Fund(id=1240413541933576872, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, awardId=null, language=CN, fundingSource=江苏中医药传承创新发展研究基地研究成果, fundOrder=null, country=null)], companyList=[AuthorCompany(id=1240413535482736911, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, xref=null, ext=[AuthorCompanyExt(id=1240413535486931217, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, companyId=1240413535482736911, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China), AuthorCompanyExt(id=1240413535499514130, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, companyId=1240413535482736911, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南京中医药大学卫生经济管理学院,江苏 南京 210023)])], figs=[ArticleFig(id=1240413537831547358, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Fig.1, caption=Three-dimensional Analytical Framework for the Construction of the Medical System in Jiangsu, figureFileSmall=qGs5XIR+Cx1+1pgMXoBJvw==, figureFileBig=qIZ6xO+XUmLSU7nIbA0UeQ==, tableContent=null), ArticleFig(id=1240413537953182184, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=图1, caption=江苏医疗体系建设三维分析框架, figureFileSmall=qGs5XIR+Cx1+1pgMXoBJvw==, figureFileBig=qIZ6xO+XUmLSU7nIbA0UeQ==, tableContent=null), ArticleFig(id=1240413538066428398, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Fig.2, caption=Policy tools for the construction of the medical system in Jiangsu, figureFileSmall=VNPFgzck105J1jvX9z4GYg==, figureFileBig=xugsGqN4SXWv+pf7pGgLqg==, tableContent=null), ArticleFig(id=1240413539584766454, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=图2, caption=江苏医疗体系建设政策工具, figureFileSmall=VNPFgzck105J1jvX9z4GYg==, figureFileBig=xugsGqN4SXWv+pf7pGgLqg==, tableContent=null), ArticleFig(id=1240413539668652546, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Fig.3, caption=Distribution map of policy issuances on medical system construction in Jiangsu Province from 2016 to 2024, figureFileSmall=HR0+af5goUElMMQsPSFTIw==, figureFileBig=Ez+bonw5sA4xBO6RL0hQ+g==, tableContent=null), ArticleFig(id=1240413539794481674, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=图3, caption=江苏省2016年至2024年医疗体系建设政策发文分布图, figureFileSmall=HR0+af5goUElMMQsPSFTIw==, figureFileBig=Ez+bonw5sA4xBO6RL0hQ+g==, tableContent=null), ArticleFig(id=1240413539916116499, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 1, caption=

Some policy documents on the construction of the medical system in Jiangsu

, figureFileSmall=null, figureFileBig=null, tableContent=
序号发文时间政策名称发文主体
12024省政府办公厅关于印发进一步完善医疗卫生服务体系实施方案的通知江苏省政府办公厅
22023江苏省基层卫生条例(2023)江苏卫健委
32024关于印发《江苏省省级临床重点专科管理办法》的通知江苏卫健委
682017“健康江苏2030”规划纲要中共江苏省委
692018关于加快推进紧密型医联体建设试点工作的通知江苏卫健委
702017省政府办公厅关于印发江苏省医疗卫生服务体系规划(2017—2020年)的通知江苏省政府办公厅
), ArticleFig(id=1240413540033557021, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表1, caption=

江苏医疗体系建设部分政策文件

, figureFileSmall=null, figureFileBig=null, tableContent=
序号发文时间政策名称发文主体
12024省政府办公厅关于印发进一步完善医疗卫生服务体系实施方案的通知江苏省政府办公厅
22023江苏省基层卫生条例(2023)江苏卫健委
32024关于印发《江苏省省级临床重点专科管理办法》的通知江苏卫健委
682017“健康江苏2030”规划纲要中共江苏省委
692018关于加快推进紧密型医联体建设试点工作的通知江苏卫健委
702017省政府办公厅关于印发江苏省医疗卫生服务体系规划(2017—2020年)的通知江苏省政府办公厅
), ArticleFig(id=1240413540155191845, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 2, caption=

Partial coding of policy texts

, figureFileSmall=null, figureFileBig=null, tableContent=
序号内容编码政策工具
12.强化数字信息赋能。建立健康医疗数据跨部门共享协作机制。1-2-5-2信息技术
2(二)加强全员培训。各医疗机构要加强对医务人员、导医、助医、志愿者等的全员培训。2-5-2人力支持
3第四条 省级临床重点专科实行总量控制、定期考评、优胜劣汰、动态调整的管理机制。3-1-4体制机制
68(一)完善全民健康教育体系。建立全民健康教育制度。广泛普及健康知识,加强健康信息发布。68-4-1-1体系能力
69(一)强化组织领导。加强组织领导,强化部门协同,有序有力推进。69-3-1组织建设
70五、加强监督考评。强化对规划实施的监督评价。70-6-5监管评价
), ArticleFig(id=1240413540322964013, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表2, caption=

政策文本部分编码

, figureFileSmall=null, figureFileBig=null, tableContent=
序号内容编码政策工具
12.强化数字信息赋能。建立健康医疗数据跨部门共享协作机制。1-2-5-2信息技术
2(二)加强全员培训。各医疗机构要加强对医务人员、导医、助医、志愿者等的全员培训。2-5-2人力支持
3第四条 省级临床重点专科实行总量控制、定期考评、优胜劣汰、动态调整的管理机制。3-1-4体制机制
68(一)完善全民健康教育体系。建立全民健康教育制度。广泛普及健康知识,加强健康信息发布。68-4-1-1体系能力
69(一)强化组织领导。加强组织领导,强化部门协同,有序有力推进。69-3-1组织建设
70五、加强监督考评。强化对规划实施的监督评价。70-6-5监管评价
), ArticleFig(id=1240413540432015924, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 3, caption=

Description of policy tools for the construction of the medical system in Jiangsu

, figureFileSmall=null, figureFileBig=null, tableContent=
工具类型二级子节点含义
供给型财政支持政府加大资金投入并对薄弱领域给予资金倾斜
人力支持培养、选拔、建设高质量的医疗人才队伍
设施设备完善医疗基础建筑、设施设备
信息技术推动运用新型信息技术,加强行业间的信息流通,提高信息化水平
科技支持大力提倡科技创新,并且推动最新技术的实践应用
资源布局主要涉及医疗机构地理分布、层级配置、类别搭配等方面
体系能力强化医疗服务、资源整合、以及健康管理等多方面的能力
优化服务着眼于流程、质量、可及性及反馈机制等多方面优化现有服务
价格调整借助多种手段协同作用,以实现医疗服务、药品耗材等价格合理
学科建设优先培育支持重点学科建设,提升学科优势
需求型政府购买政府运用财政资金,向社会各类医疗服务提供主体集中采购医疗相关服务
协调合作鼓励不同的机构、部门之间互相交流合作
试点示范选取部分地区、医疗机构或特定医疗项目作为试点。
环境型目标规划设置医疗体系建设总体的目标和长远的规划
规则标准建立具有约束性的规范要求与衡量准则,用以指导和规范各参与主体行为。
平台搭建整合信息技术、医疗资源等要素,构建功能性平台。
机制制度制定或完善医疗行业一系列制度以及机制,引领医疗行业规范化发展
策略措施制定和完善相关配套措施促进江苏医疗体系短期内的发展
监管评价建立健全专门的监督管理与绩效评估体系,对医疗行业进行常态化的监督与评价
组织建设合理规划与构建各级各类医疗相关组织架构,明确各组织的职能定位
法制建设制定、完善并落实相关法律法规,构建起坚实的法治框架
宣传引导宣传解读相关措施,创造良好氛围
), ArticleFig(id=1240413540553650747, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表3, caption=

政策工具描述

, figureFileSmall=null, figureFileBig=null, tableContent=
工具类型二级子节点含义
供给型财政支持政府加大资金投入并对薄弱领域给予资金倾斜
人力支持培养、选拔、建设高质量的医疗人才队伍
设施设备完善医疗基础建筑、设施设备
信息技术推动运用新型信息技术,加强行业间的信息流通,提高信息化水平
科技支持大力提倡科技创新,并且推动最新技术的实践应用
资源布局主要涉及医疗机构地理分布、层级配置、类别搭配等方面
体系能力强化医疗服务、资源整合、以及健康管理等多方面的能力
优化服务着眼于流程、质量、可及性及反馈机制等多方面优化现有服务
价格调整借助多种手段协同作用,以实现医疗服务、药品耗材等价格合理
学科建设优先培育支持重点学科建设,提升学科优势
需求型政府购买政府运用财政资金,向社会各类医疗服务提供主体集中采购医疗相关服务
协调合作鼓励不同的机构、部门之间互相交流合作
试点示范选取部分地区、医疗机构或特定医疗项目作为试点。
环境型目标规划设置医疗体系建设总体的目标和长远的规划
规则标准建立具有约束性的规范要求与衡量准则,用以指导和规范各参与主体行为。
平台搭建整合信息技术、医疗资源等要素,构建功能性平台。
机制制度制定或完善医疗行业一系列制度以及机制,引领医疗行业规范化发展
策略措施制定和完善相关配套措施促进江苏医疗体系短期内的发展
监管评价建立健全专门的监督管理与绩效评估体系,对医疗行业进行常态化的监督与评价
组织建设合理规划与构建各级各类医疗相关组织架构,明确各组织的职能定位
法制建设制定、完善并落实相关法律法规,构建起坚实的法治框架
宣传引导宣传解读相关措施,创造良好氛围
), ArticleFig(id=1240413540654314054, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 4, caption=

Distribution of policy tools in dimension X

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工具类型二级子节点频次占比
(%)
供给型(376,34.78%)财政支持201.85
人力支持746.85
设施设备50.46
信息技术454.16
科技支持121.11
资源布局211.94
体系能力989.07
优化服务767.03
价格调整171.57
学科建设80.74
需求型(69,6.38%)政府购买10.09
协调合作585.37
试点示范100.93
环境型(636,58.83%)目标规划666.11
规则标准12611.66
平台搭建201.85
机制制度1049.62
策略措施12811.84
监管评价807.40
组织建设595.46
法制建设181.67
宣传引导353.24
), ArticleFig(id=1240413540796920402, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表4, caption=

X维度政策工具分布

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工具类型二级子节点频次占比
(%)
供给型(376,34.78%)财政支持201.85
人力支持746.85
设施设备50.46
信息技术454.16
科技支持121.11
资源布局211.94
体系能力989.07
优化服务767.03
价格调整171.57
学科建设80.74
需求型(69,6.38%)政府购买10.09
协调合作585.37
试点示范100.93
环境型(636,58.83%)目标规划666.11
规则标准12611.66
平台搭建201.85
机制制度1049.62
策略措施12811.84
监管评价807.40
组织建设595.46
法制建设181.67
宣传引导353.24
), ArticleFig(id=1240413540897583705, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 5, caption=

Two-Dimensional distribution of X—Y [n(%)]

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政策工具类型政策发展过程
政策规划政策实施政策监督政策评价
财政支持5(0.46)15(1.39)0(0.00)0(0.00)
人力支持28(2.59)46(4.26)0(0.00)0(0.00)
设施设备3(0.28)1(0.09)1(0.09)0(0.00)
信息技术23(2.13)20(1.85)2(0.19)0(0.00)
科技支持8(0.74)4(0.37)0(0.00)0(0.00)
资源布局16(1.48)5(0.46)0(0.00)0(0.00)
体系能力57(5.27)39(3.60)0(0.00)2(0.19)
优化服务48(4.44)28(2.59)0(0.00)0(0.00)
价格调整3(0.28)12(1.11)2(0.19)0(0.00)
学科建设4(0.37)4(0.37)0(0.00)0(0.00)
供给型合计195(18.04)174(16.10)5(0.46)2(0.19)
政府购买0(0.00)1(0.09)0(0.00)0(0.00)
协调合作27(2.50)27(2.50)4(0.37)0(0.00)
试点示范1(0.09)9(0.83)0(0.00)0(0.00)
需求型合计28(2.60)37(3.42)4(0.37)0(0.00)
目标规划27(2.50)31(2.87)7(0.65)1(0.09)
规则标准27(2.50)92(8.51)4(0.37)3(0.28)
平台搭建9(0.83)11(1.02)0(0.00)0(0.00)
机制制度39(3.61)57(5.27)8(0.74)0(0.00)
策略措施47(4.35)66(6.11)13(1.20)2(0.19)
监管评价27(2.50)37(3.42)15(1.39)1(0.09)
组织建设20(1.85)30(2.78)8(0.74)1(0.09)
法制建设4(0.37)12(1.11)2(0.19)0(0.00)
宣传引导12(1.11)18(1.67)4(0.37)1(0.09)
环境型合计212(19.61)354(32.75)61(5.64)9(0.83)
总计435(40.24)565(52.27)70(6.48)11(1.02)
), ArticleFig(id=1240413540994052704, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表5, caption=

X—Y二维分布[n(%)]

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政策工具类型政策发展过程
政策规划政策实施政策监督政策评价
财政支持5(0.46)15(1.39)0(0.00)0(0.00)
人力支持28(2.59)46(4.26)0(0.00)0(0.00)
设施设备3(0.28)1(0.09)1(0.09)0(0.00)
信息技术23(2.13)20(1.85)2(0.19)0(0.00)
科技支持8(0.74)4(0.37)0(0.00)0(0.00)
资源布局16(1.48)5(0.46)0(0.00)0(0.00)
体系能力57(5.27)39(3.60)0(0.00)2(0.19)
优化服务48(4.44)28(2.59)0(0.00)0(0.00)
价格调整3(0.28)12(1.11)2(0.19)0(0.00)
学科建设4(0.37)4(0.37)0(0.00)0(0.00)
供给型合计195(18.04)174(16.10)5(0.46)2(0.19)
政府购买0(0.00)1(0.09)0(0.00)0(0.00)
协调合作27(2.50)27(2.50)4(0.37)0(0.00)
试点示范1(0.09)9(0.83)0(0.00)0(0.00)
需求型合计28(2.60)37(3.42)4(0.37)0(0.00)
目标规划27(2.50)31(2.87)7(0.65)1(0.09)
规则标准27(2.50)92(8.51)4(0.37)3(0.28)
平台搭建9(0.83)11(1.02)0(0.00)0(0.00)
机制制度39(3.61)57(5.27)8(0.74)0(0.00)
策略措施47(4.35)66(6.11)13(1.20)2(0.19)
监管评价27(2.50)37(3.42)15(1.39)1(0.09)
组织建设20(1.85)30(2.78)8(0.74)1(0.09)
法制建设4(0.37)12(1.11)2(0.19)0(0.00)
宣传引导12(1.11)18(1.67)4(0.37)1(0.09)
环境型合计212(19.61)354(32.75)61(5.64)9(0.83)
总计435(40.24)565(52.27)70(6.48)11(1.02)
), ArticleFig(id=1240413541082133094, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 6, caption=

Two-Dimensional distribution of X—Z [n(%)]

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政策工具类型政策目标
加快公立医院高质量发展健全分级诊疗制度强化医保政策支撑完善医防协同机制推动医教研产融合发展
财政支持7(0.80)4(0.46)1(0.11)0(0.00)5(0.57)
人力支持30(3.43)8(0.91)0(0.00)7(0.80)24(2.74)
设施设备2(0.23)0(0.00)1(0.11)0(0.00)0(0.00)
信息技术12(1.37)9(1.03)1(0.11)6(0.69)14(1.60)
科技支持6(0.69)1(0.11)0(0.00)0(0.00)3(0.34)
资源布局2(0.23)10(1.14)0(0.00)5(0.57)2(0.23)
体系能力30(3.43)22(2.51)1(0.11)27(3.09)7(0.80)
优化服务31(3.54)26(2.97)3(0.34)8(0.91)0(0.00)
价格调整2(0.23)0(0.00)12(1.37)0(0.00)0(0.00)
学科建设1(0.11)2(0.23)0(0.00)0(0.00)3(0.34)
供给型合计123(14.06)82(9.37)19(2.17)53(6.06)58(6.63)
政府购买0(0.00)0(0.00)0(0.00)0(0.00)0(0.00)
协调合作14(1.60)14((1.60)2(0.23)16(1.83)1(0.11)
试点示范6(0.69)1(0.11)0(0.00)0(0.00)2(0.23)
需求型合计20(2.29)15(1.71)2(0.23)16(1.83)3(0.34)
目标规划23(2.63)7(0.80)8(0.91)5(0.57)6(0.69)
规则标准58(6.63)15(1.71)9(1.03)8(0.91)15(1.71)
平台搭建7(0.80)4(0.46)0(0.00)2(0.23)2(0.23)
机制制度33(3.77)14(1.60)16(1.83)10(1.14)8(0.91)
策略措施38(4.34)28(3.20)10(1.14)15(1.71)5(0.57)
监管评价26(2.97)10(1.14)7(0.80)6(0.69)3(0.34)
组织建设26(2.97)4(0.46)5(0.57)7(0.80)3(0.34)
法制建设13(1.49)0(0.00)0(0.00)0(0.00)0(0.00)
宣传引导19(2.17)3(0.34)3(0.34)2(0.23)1(0.11)
环境型合计243(27.77)85(9.71)58(6.63)55(6.29)43(4.91)
总计386(44.11)182(20.80)79(9.03)124(14.17)104(11.89)
), ArticleFig(id=1240413541207962224, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表6, caption=

X—Z二维分布[n(%)]

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政策工具类型政策目标
加快公立医院高质量发展健全分级诊疗制度强化医保政策支撑完善医防协同机制推动医教研产融合发展
财政支持7(0.80)4(0.46)1(0.11)0(0.00)5(0.57)
人力支持30(3.43)8(0.91)0(0.00)7(0.80)24(2.74)
设施设备2(0.23)0(0.00)1(0.11)0(0.00)0(0.00)
信息技术12(1.37)9(1.03)1(0.11)6(0.69)14(1.60)
科技支持6(0.69)1(0.11)0(0.00)0(0.00)3(0.34)
资源布局2(0.23)10(1.14)0(0.00)5(0.57)2(0.23)
体系能力30(3.43)22(2.51)1(0.11)27(3.09)7(0.80)
优化服务31(3.54)26(2.97)3(0.34)8(0.91)0(0.00)
价格调整2(0.23)0(0.00)12(1.37)0(0.00)0(0.00)
学科建设1(0.11)2(0.23)0(0.00)0(0.00)3(0.34)
供给型合计123(14.06)82(9.37)19(2.17)53(6.06)58(6.63)
政府购买0(0.00)0(0.00)0(0.00)0(0.00)0(0.00)
协调合作14(1.60)14((1.60)2(0.23)16(1.83)1(0.11)
试点示范6(0.69)1(0.11)0(0.00)0(0.00)2(0.23)
需求型合计20(2.29)15(1.71)2(0.23)16(1.83)3(0.34)
目标规划23(2.63)7(0.80)8(0.91)5(0.57)6(0.69)
规则标准58(6.63)15(1.71)9(1.03)8(0.91)15(1.71)
平台搭建7(0.80)4(0.46)0(0.00)2(0.23)2(0.23)
机制制度33(3.77)14(1.60)16(1.83)10(1.14)8(0.91)
策略措施38(4.34)28(3.20)10(1.14)15(1.71)5(0.57)
监管评价26(2.97)10(1.14)7(0.80)6(0.69)3(0.34)
组织建设26(2.97)4(0.46)5(0.57)7(0.80)3(0.34)
法制建设13(1.49)0(0.00)0(0.00)0(0.00)0(0.00)
宣传引导19(2.17)3(0.34)3(0.34)2(0.23)1(0.11)
环境型合计243(27.77)85(9.71)58(6.63)55(6.29)43(4.91)
总计386(44.11)182(20.80)79(9.03)124(14.17)104(11.89)
), ArticleFig(id=1240413541333791354, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=EN, label=Table 7, caption=

Two-Dimensional distribution of Y—Z [n(%)]

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政策目标政策发展过程
政策规划政策实施政策监督政策评价
加快公立医院高质量发展16(15.38)19(18.27)3(2.88)1(0.96)
健全分级诊疗制度11(10.58)9(8.65)0(0.00)0(0.00)
强化医保政策支撑4(3.85)7(6.73)2(1.92)0(0.00)
完善医防协同机制9(8.65)7(6.73)0(0.00)0(0.00)
推动医教研产融合发展8(7.69)8(7.69)0(0.00)0(0.00)
), ArticleFig(id=1240413541438648962, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1240395013838926822, language=CN, label=表7, caption=

Y—Z二维分布[n(%)]

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政策目标政策发展过程
政策规划政策实施政策监督政策评价
加快公立医院高质量发展16(15.38)19(18.27)3(2.88)1(0.96)
健全分级诊疗制度11(10.58)9(8.65)0(0.00)0(0.00)
强化医保政策支撑4(3.85)7(6.73)2(1.92)0(0.00)
完善医防协同机制9(8.65)7(6.73)0(0.00)0(0.00)
推动医教研产融合发展8(7.69)8(7.69)0(0.00)0(0.00)
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政策工具视角下江苏医疗体系建设政策文本分析
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王飞 , 徐佩 , 陈志影
现代预防医学 | 卫生政策与管理 2025,52(14): 2588-2593
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现代预防医学 | 卫生政策与管理 2025, 52(14): 2588-2593
政策工具视角下江苏医疗体系建设政策文本分析
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王飞, 徐佩 , 陈志影
作者信息
  • 南京中医药大学卫生经济管理学院,江苏 南京 210023
  • 王飞(2001—),男,硕士在读,研究方向:卫生政策与管理

通讯作者:

徐佩,E-mail:
An analysis of policy texts on healthcare system development from the perspective of policy instruments, Jiangsu
Fei WANG, Pei XU , Zhi-ying CHEN
Affiliations
  • School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
出版时间: 2025-07-25 doi: 10.20043/j.cnki.MPM.202503288
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目的

分析总结江苏省医疗体系建设政策的构成特点与问题,为江苏医疗体系建设的优化与完善提供借鉴。

方法

采用Rothwell和Zegveld政策工具分类方法,构建政策工具—政策发展过程—政策目标三维分析框架,对十三五及十四五期间发布的70份政策文本进行量化分析。

结果

政策工具维度下以环境型(58.83%)为主,其次是供给型(34.78%),需求型(6.38%)最少。政策发展过程维度以政策实施(52.27%)和政策规划(40.24%)为主,政策监督(6.48%)及政策评价(1.02%)占比则较小。政策目标维度加快公立医院高质量发展(44.11%)最多而强化医保政策支撑(9.03%)最少。

结论

政策工具结构不均衡,政策过程结果呈现离散状态,政策目标建设重点分化。建议适度增加需求型工具的使用,优化政策工具结构,统筹规划政策发展过程和政策目标建设。

江苏省  /  医疗体系  /  政策工具  /  内容分析法
Objective

To analyze the characteristics and issues of Jiangsu’s healthcare system policies and provide optimization insights.

Methods

Using Rothwell and Zegveld’s policy tool classification, a three-dimensional framework (policy tools, development process, policy goals) was constructed to quantify 70 policy texts from the 13th and 14th Five-Year Plan periods.

Results

Policy tools: environmental-type dominated (58.83%), followed by supply-type (34.78%), demand-type (6.38%) was minimal. Policy process: implementation (52.27%) and planning (40.24%) prevailed, while supervision (6.48%) and evaluation (1.02%) were underdeveloped. Policy goals: advancing public hospital quality (44.11%) was prioritized, whereas strengthening medical insurance (9.03%) lagged.

Conclusion

Structural imbalance in policy tools, fragmented policy processes, and divergent goals were observed. Recommendations: optimize tool allocation by increasing demand-type tools, integrate policy processes, and align goals systematically.

Jiangsu Province  /  Healthcare system  /  Policy tool  /  Content analysis method
王飞, 徐佩, 陈志影. 政策工具视角下江苏医疗体系建设政策文本分析. 现代预防医学, 2025 , 52 (14) : 2588 -2593 . DOI: 10.20043/j.cnki.MPM.202503288
Fei WANG, Pei XU, Zhi-ying CHEN. An analysis of policy texts on healthcare system development from the perspective of policy instruments, Jiangsu[J]. Modern Preventive Medicine, 2025 , 52 (14) : 2588 -2593 . DOI: 10.20043/j.cnki.MPM.202503288
随着社会经济的发展和疾病谱的转变,人口老龄化等趋势让医疗服务需求不断变化[1]。当前,人民群众健康需求的提升对医疗卫生服务体系建设提出了更高要求[2]。2023年3月,中共中央办公厅、国务院办公厅印发《关于进一步完善医疗卫生服务体系的意见》,强调建立中国特色优质高效的医疗卫生服务体系。江苏于2024年2月发布《关于进一步完善医疗卫生服务体系实施方案的通知》,提出构建有江苏特色的现代医疗卫生服务体系。医疗卫生服务体系是保障城乡居民享有基本医疗卫生服务的基础[3]。高效医疗体系的构建需要政策的正确指引,政策目标的实现依赖于政策工具的合理选择与科学运用[4]。适宜的政策工具能使医疗卫生服务体系建设与政策目标趋同,实现科学决策[5]。本文基于政策工具理论,对江苏省现有医疗体系建设相关政策文本进行量化分析,明确其结构特点与不足,为完善江苏医疗体系建设政策、推动其优质高效发展提供参考。
通过“北大法宝数据库”以及江苏人民政府、卫健委等官网,以“医疗”、“医院”、“医护人员”等为关键词检索,起止时间为2016年至2024年。
依据纳入和排除标准筛选文件。纳入标准:体现江苏省总体意志;与医疗体系建设直接相关;文件类型为法律法规、规划纲要、意见、通知等规范性文本。排除标准:仅出现关键词,但无涉及江苏医疗服务体系建设的实质内容。经筛选,确定70份有效政策,部分政策见表1
运用内容分析法,借助Excel 2021对筛选出的江苏医疗体系建设政策文本进行信息提取与量化分析。编码格式为“政策编号-一级标题-二级标题-三级标题”,最终获得1 081条编码,部分编码如表2所示。
基于已有基础,构建政策工具-政策发展过程-政策目标三维分析框架来进行具体的分析。三维框架如图1所示。
本文以Rothwell[6]所提出的三分类模型作为理论支撑,将政策工具划分为供给型、需求型以及环境型三个维度。结合相关文献[7-9]细化了二级子节点的内容,见表3。供给型政策工具直接助力医疗体系建设。需求型政策工具拉动医疗体系的建设工作。环境型政策工具为医疗体系建设营造良好环境,间接引领其建设。三类政策工具相互配合,共同推进江苏医疗体系建设(图2)。
医疗体系建设政策的制定到后续的实施以及监督评价是一个动态发展的过程。按照张招椿等人[10]的相关研究,可把政策过程细分为政策规划、政策实施、政策监督以及政策评价四个过程。
根据《省政府办公厅关于印发进一步完善医疗卫生服务体系实施方案的通知》,将本文的目标分为五个维度。分别是加快公立医院高质量发展、健全分级诊疗制度、强化医保政策支撑、完善医防协同机制以及推动医教研产融合发展。
图3中,2016至2020年的发文数总体要多于2021年至2024年。但并不代表江苏放慢建设步伐,不同时期的政策有所区别。前者侧重卫生与健康体系的基础构建与初步改革,涉及医疗服务价格调整、医教协同、医疗救助完善等方面。而后者聚焦深化专项治理与高质量发展,如不合理医疗检查治理、落实医疗机构责任制度、精细化规划护理及各类医疗事业、推进互联网医疗服务等。
X维度下政策文本分布情况见表4,政策文本分布以环境型(58.83%)为主,其次是供给型(34.78%),需求型(6.38%)最少。内部二级子节点的分布也不均衡。供给型中体系能力(9.07%)使用最多,设施设备(0.46%)等使用较少。需求型中协调合作(5.37%)占比最高,政府购买(0.09%)占比较小。环境型中策略措施(11.84%)等占比较高,法制建设(5.46%)占比则较小。
X—Y二维分析结果见表5。政策发展过程以政策实施(52.27%)和政策规划(40.24%)为主,政策监督(6.48%)及政策评价(1.02%)占比较小。四个维度中均是以环境型政策工具最多,供给型次之,需求型最少。
X—Z二维分布结果见表6。江苏医疗体系建设政策目标中加快公立医院高质量发展(44.11%)的使用频率最高而强化医保政策支撑(9.03%)的使用频率最低。推动医教研产融合发展(11.89%)中供给型政策工具使用最多,其余维度中均是以环境型政策工具为主。
Y—Z二维分布结果见表7。政策目标五个维度的相关政策目前还处在政策规划和政策实施阶段,缺少对于政策监督和政策规划的使用。
X维度结果显示,江苏省医疗体系建设政策有一定的倾向性,重视供给型和环境型政策的使用,需求型政策使用很少。需求型工具能为医疗体系建设提供拉力,是相关政策推进的直接动力[11]。目前,需求型政策工具相对缺乏,使得政策工具结构出现不均衡状况。虽然这不一定会完全阻碍政策发展,但要明白,其不足可能会削弱多元主体参与医疗服务体系建设的积极性,延长政策低效阶段,影响政策效果发挥[12]。所以,政府相关部门制定政策时,应多考虑需求型政策工具,不过也要谨慎行事,紧密结合实际发展阶段与需求,保障政策调整科学合理。
Y维度分析显示,江苏省医疗政策体系以规划与实施为主,体现政府部门通过科学规划与分级诊疗、智慧医疗等举措有序推进体系建设,凸显战略引领作用。但监督评价环节占比不足10%,存在重部署轻评估现象,对政策执行效能跟踪及动态优化不足。建议强化闭环管理,制定可量化的监测指标与问责机制,建立政策实施效果动态评估体系,通过数据反馈及时调整完善,确保政策的系统性落实。
表6中,江苏省医疗体系建设政策目标呈差异化特征。“加快公立医院高质量发展”占据主导,其中环境型政策工具使用最多,主要聚焦规则标准、机制制度等建设,凸显通过顶层设计推动公立医院转型。“医教研产融合”中供给型工具通过人才培养、信息化投入提供基础支撑,但环境型工具缺失导致产学研协同创新机制薄弱。建议完善医教研产政策组合,通过税收优惠、知识产权保护等环境型工具激发协同创新活力,实现政策工具与战略目标的动态适配。
表7中,政策目标现阶段大多集中在政策规划与实施阶段。这表明当前相关部门积极着手对各项医疗体系建设目标进行谋划并付诸实践,致力于推动各项工作有序开展,展现出主动作为的积极态势。但是在政策监督和政策评价方面的使用明显不足,多个目标维度甚至出现零占比的情况。这意味着在政策推进过程中,缺乏有效的监督与评价机制来把控政策执行是否到位、并且难以精准知晓政策的实际成效以及存在的问题。后续应着重加强政策监督与评价体系的构建,保障医疗体系建设达到预期目标。
  • 教育部人文社会科学研究规划基金项目(23YJA630106)
  • 江苏省社会科学基金项目(23JZB007)
  • 江苏中医药传承创新发展研究基地研究成果
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2025年第52卷第14期
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doi: 10.20043/j.cnki.MPM.202503288
  • 接收时间:2025-03-14
  • 首发时间:2026-03-16
  • 出版时间:2025-07-25
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  • 收稿日期:2025-03-14
基金
教育部人文社会科学研究规划基金项目(23YJA630106)
江苏省社会科学基金项目(23JZB007)
江苏中医药传承创新发展研究基地研究成果
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    南京中医药大学卫生经济管理学院,江苏 南京 210023

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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