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Article(id=1241759327384567812, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202405199, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1715616000000, receivedDateStr=2024-05-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773988094375, onlineDateStr=2026-03-20, pubDate=1727193600000, pubDateStr=2024-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773988094375, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773988094375, creator=13701087609, updateTime=1773988094375, updator=13701087609, issue=Issue{id=1241759317016252418, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='18', pageStart='3265', pageEnd='3456', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773988091898, creator=13701087609, updateTime=1773991617194, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774103024174010, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774103024174011, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3368, endPage=3373, ext={EN=ArticleExt(id=1241759329259421714, articleId=1241759327384567812, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Quantitative evaluation of Guangxi thalassemia prevention and control policies based on PMC index model, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze and evaluate the prevention and control policies for thalassemia, identify the usage and distribution of policy tools, as well as the advantages and disadvantages of the policies, and propose improvement suggestions.

Methods

From the perspective of policy instruments, an analytical framework of "policy tools-stakeholders" has been constructed. Utilizing the Policy Modeling Consistency (PMC) index model, a quantitative evaluation was conducted. The characteristics of policy tool usage were identified, problems in the policies were discovered, and strategies for policy optimization were explored.

Results

The study found that the overall quality of Guangxi’s thalassemia prevention and control policies is relatively high, but there are also issues such as fewer joint documents issued by multiple departments, lack of demand-oriented policy tools (18.46%), slightly vague policy nature, and difficulty in balancing long-term and short-term policy effectiveness.

Conclusion

The prevention and treatment policy for Mediterranean anemia should start by enhancing the utilization of demand-driven tools, taking into account the short-term and long-term effectiveness of the policy, and mobilizing the participation of multiple stakeholders to improve policy quality.

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目的

分析评价地中海贫血防治政策、发现其政策工具使用与分布情况以及政策优缺点，提出改进建议。

方法

基于政策工具的视角，构建了“政策工具-利益相关者”的分析框架、借助政策一致性指数模型（Policy Modeling Consistency，PMC），进行定量评价。

结果

研究发现：广西地中海贫血防治政策总体质量较高，但也存在着多部门联合发文较少，缺乏需求型政策工具运用（18.46%），政策性质略显模糊，政策时效难以做到长期与短期兼顾等问题。

结论

地中海贫血防治政策应从增加需求型工具利用、兼顾政策长短期时效、动员多主体参与等方面入手提升政策质量。

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李忠友，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=WUGaxgCF7jZpW/q7FY/CKg==, magXml=CvTXW2wxJ1TzNoO9/0B7eQ==, pdfUrl=null, pdf=ea8sWW24G3hjMbsdWRnWVw==, pdfFileSize=943844, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=sQyYIk4htn9Xq5ljkp/YfQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=WSZEMZtPglDBtupWHtsUhg==, mapNumber=null, authorCompany=null, fund=null, authors=

魏海斌（1990—），男，博士在读，研究方向：卫生政策与健康不平等治理

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魏海斌（1990—），男，博士在读，研究方向：卫生政策与健康不平等治理

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Modern Preventive Medicine, 2023, 50(21): 3947-3952.（In Chinese), articleTitle=China’s quantitative evaluation by disease score payment (DIP) policy ——based on PMC index model, refAbstract=null), Reference(id=1241759367553417528, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=6, pageStart=711, pageEnd=720, url=null, language=null, rfNumber=[17], rfOrder=29, authorNames=李玉敏, 陈丹镝, journalName=预防医学情报杂志, refType=null, unstructuredReference=李玉敏，陈丹镝．基于PMC指数模型的2002—2023年我国职业病防治政策文本量化评价[J]．预防医学情报杂志，2024，40（6）：711-720．, articleTitle=基于PMC指数模型的2002—2023年我国职业病防治政策文本量化评价, refAbstract=null), Reference(id=1241759367654080826, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, doi=null, pmid=null, pmcid=null, year=2024, volume=40, issue=6, pageStart=711, pageEnd=720, url=null, language=null, rfNumber=[17], rfOrder=30, authorNames=Li YM, Chen DD, journalName=Journal of Preventive Medicine Information, refType=null, unstructuredReference=Li YM, Chen DD. Quantitative evaluation of National policy texts on occupational disease prevention and control in China from 2002 to 2023 based on PMC index model[J]. Journal of Preventive Medicine Information, 2024, 40(6): 711-720.（In Chinese), articleTitle=Quantitative evaluation of National policy texts on occupational disease prevention and control in China from 2002 to 2023 based on PMC index model, refAbstract=null), Reference(id=1241759367754744126, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, doi=null, pmid=null, pmcid=null, year=2021, volume=38, issue=2, pageStart=103, pageEnd=108, url=null, language=null, rfNumber=[18], rfOrder=31, authorNames=张文静, 张丽, 姚俊, journalName=中国卫生事业管理, refType=null, unstructuredReference=张文静，张丽，姚俊．长期护理保险制度政策评价:基于PMC指数模型[J]．中国卫生事业管理，2021，38（2）：103-108．, articleTitle=长期护理保险制度政策评价:基于PMC指数模型, refAbstract=null), Reference(id=1241759367855407426, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, doi=null, pmid=null, pmcid=null, year=2021, volume=38, issue=2, pageStart=103, pageEnd=108, url=null, language=null, rfNumber=[18], rfOrder=32, authorNames=Zhang WJ, Zhang L, Yao J, journalName=Chinese Health Service Management, refType=null, unstructuredReference=Zhang WJ, Zhang L, Yao J. Evaluation of long term care insurance system policy based on PMC index model[J]. Chinese Health Service Management, 2021, 38(2): 103-108.（In Chinese), articleTitle=Evaluation of long term care insurance system policy based on PMC index model, refAbstract=null)], funds=[Fund(id=1241759356576924640, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, awardId=H202208, language=CN, fundingSource=广西壮族自治区卫生健康委横向课题(H202208), fundOrder=null, country=null), Fund(id=1241759356706948078, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, awardId=2022KY0266, language=CN, fundingSource=2022年广西高校中青年教师科研基础能力提升项目(2022KY0266), fundOrder=null, country=null), Fund(id=1241759356836971516, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, awardId=2022A009, language=CN, fundingSource=广西中医药大学高层次公共卫生人才培育创新团队资助项目(2022A009), fundOrder=null, country=null), Fund(id=1241759356962799622, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, awardId=2022C010, language=CN, fundingSource=广西中医药大学桂派杏林拔尖人才项目(2022C010), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241759336268103785, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, xref=1., ext=[AuthorCompanyExt(id=1241759336289075306, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, companyId=1241759336268103785, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Administration, Guangxi University, Nanning, Guangxi 530004, China), AuthorCompanyExt(id=1241759336314241131, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, companyId=1241759336268103785, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.广西大学公共管理学院，广西 南宁 530004)]), AuthorCompany(id=1241759337706750085, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, xref=2., ext=[AuthorCompanyExt(id=1241759337790636169, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, companyId=1241759337706750085, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广西中医药大学公共卫生与管理学院)]), AuthorCompany(id=1241759337987768471, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, xref=3., ext=[AuthorCompanyExt(id=1241759337996157080, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, companyId=1241759337987768471, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.广西壮族自治区妇幼保健院)]), AuthorCompany(id=1241759338113597598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, xref=4., ext=[AuthorCompanyExt(id=1241759338151346337, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, companyId=1241759338113597598, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.广西中医药科技成果转化与应用协同创新中心)])], figs=[ArticleFig(id=1241759349580825257, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Fig.1, caption=Trend of Birth Rate (Number of Births) of Severe Thalassemia Fetuses in Guangxi, figureFileSmall=5Gw24xx3zE3aSE6BnrOIzQ==, figureFileBig=sQyYIk4htn9Xq5ljkp/YfQ==, tableContent=null), ArticleFig(id=1241759351128523442, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=图1, caption=广西全区重型地贫胎儿出生率（出生人数）变化趋势, figureFileSmall=5Gw24xx3zE3aSE6BnrOIzQ==, figureFileBig=sQyYIk4htn9Xq5ljkp/YfQ==, tableContent=null), ArticleFig(id=1241759351539565259, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Fig.2, caption=A Distribution Diagram of Policy Instrument Nodes; 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List of Thalassemia Prevention and Control Policy Textual Materials

, figureFileSmall=null, figureFileBig=null, tableContent=
序号颁布时间颁布机构文件名称周期类型对象
P12010年5月广西壮族自治区人民政府办公厅关于印发地中海贫血防治计划的通知5年防治计划各市、县人民政府，自治区农垦局，自治区人民政府各组成部门、各直属机构
P22016年5月广西壮族自治区卫生计生委关于印发广西出生缺陷医学干预实施方案（试行）和广西重大致死致残出生缺陷评审方案的通知5年评审方案各市卫生计生委
P32016年10月广西壮族自治区卫生和计划生育委员会等十个部门关于印发《广西出生缺陷预防控制指导意见的通知》5年指导意见各市卫生计生委、党委宣传部、发改委、财政局、教育局、民政局、新闻出版广电局、妇儿工委办、总工会、妇联、残联、共青团
P42018年7月广西壮族自治区人民政府办公厅关于印发广西严重类型地中海贫血胎儿零出生计划实施方案的通知长期实施方案各市、县人民政府，自治区人民政府各组成部门、各直属机构
P52019年4月广西壮族自治区防治地中海贫血工作领导小组办公室关于印发2019年广西地中海贫血防控工作实施方案的通知1年实施方案各市地贫领导小组办公室，各市、县（市、区）卫生健康委（局）
P62019年4月广西壮族自治区人民政府办公厅关于印发广西地中海贫血防治三年行动计划（2019～2021年）的通知3年行动计划各市、县人民政府，自治区人民政府各组成部门、各直属机构
P72019年4月广西壮族自治区卫生健康委员会关于印发广西出生缺陷综合防治方案的通知3年防治方案各市卫生健康委，区直各医疗保健机构
P82021年4月自治区卫生健康委等四个部门关于印发《2021年广西免费婚前医学检查和孕前优生健康检查实施方案》等7个方案的通知1年实施方案各市、县（市、区）卫生健康委（局）、妇儿工委办、残联
P92022年3月广西壮族自治区卫生健康委员会关于印发广西健康儿童行动提升计划实施方案（2021～2025年）的通知5年实施方案各市、县（市、区）卫生健康委（局），区直医疗保健机构
P102019年9月广西壮族自治区卫生健康委员会等三个部门关于印发广西地中海贫血防控免费技术服务实施方案的通知2年实施方案各市、县（市、区）卫生健康委（局），区直相关医疗机构
P112020年9月广西壮族自治区红十字会等五个部门关于印发广西重型地中海贫血患者专项救助实施方案的通知1年实施方案各市、县（市、区）红十字会、民政局、卫生健康委、医疗保障局，自治区妇幼保健院、广西红十字基金会
P122021年4月自治区医保局等四个部门关于做好地中海贫血患者医疗救助工作的通知工作通知各市医疗保障局、财政局、卫生健康委、民政局
), ArticleFig(id=1241759352688804626, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表1, caption=

地贫防治政策文本资料一览表

, figureFileSmall=null, figureFileBig=null, tableContent=
序号颁布时间颁布机构文件名称周期类型对象
P12010年5月广西壮族自治区人民政府办公厅关于印发地中海贫血防治计划的通知5年防治计划各市、县人民政府，自治区农垦局，自治区人民政府各组成部门、各直属机构
P22016年5月广西壮族自治区卫生计生委关于印发广西出生缺陷医学干预实施方案（试行）和广西重大致死致残出生缺陷评审方案的通知5年评审方案各市卫生计生委
P32016年10月广西壮族自治区卫生和计划生育委员会等十个部门关于印发《广西出生缺陷预防控制指导意见的通知》5年指导意见各市卫生计生委、党委宣传部、发改委、财政局、教育局、民政局、新闻出版广电局、妇儿工委办、总工会、妇联、残联、共青团
P42018年7月广西壮族自治区人民政府办公厅关于印发广西严重类型地中海贫血胎儿零出生计划实施方案的通知长期实施方案各市、县人民政府，自治区人民政府各组成部门、各直属机构
P52019年4月广西壮族自治区防治地中海贫血工作领导小组办公室关于印发2019年广西地中海贫血防控工作实施方案的通知1年实施方案各市地贫领导小组办公室，各市、县（市、区）卫生健康委（局）
P62019年4月广西壮族自治区人民政府办公厅关于印发广西地中海贫血防治三年行动计划（2019～2021年）的通知3年行动计划各市、县人民政府，自治区人民政府各组成部门、各直属机构
P72019年4月广西壮族自治区卫生健康委员会关于印发广西出生缺陷综合防治方案的通知3年防治方案各市卫生健康委，区直各医疗保健机构
P82021年4月自治区卫生健康委等四个部门关于印发《2021年广西免费婚前医学检查和孕前优生健康检查实施方案》等7个方案的通知1年实施方案各市、县（市、区）卫生健康委（局）、妇儿工委办、残联
P92022年3月广西壮族自治区卫生健康委员会关于印发广西健康儿童行动提升计划实施方案（2021～2025年）的通知5年实施方案各市、县（市、区）卫生健康委（局），区直医疗保健机构
P102019年9月广西壮族自治区卫生健康委员会等三个部门关于印发广西地中海贫血防控免费技术服务实施方案的通知2年实施方案各市、县（市、区）卫生健康委（局），区直相关医疗机构
P112020年9月广西壮族自治区红十字会等五个部门关于印发广西重型地中海贫血患者专项救助实施方案的通知1年实施方案各市、县（市、区）红十字会、民政局、卫生健康委、医疗保障局，自治区妇幼保健院、广西红十字基金会
P122021年4月自治区医保局等四个部门关于做好地中海贫血患者医疗救助工作的通知工作通知各市医疗保障局、财政局、卫生健康委、民政局
), ArticleFig(id=1241759352885936926, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Table 2, caption=

Variable Settings for the Thalassemia Prevention and Control Policy PMC Model

, figureFileSmall=null, figureFileBig=null, tableContent=
编号一级变量编号二级变量编号二级变量
X1政策性质X1:1描述X1:2方案
X1:3计划
X2政策功能X2:1明确权责X2:2规范引导
X2:3分类监管X2:4联动管理
X3政策时效X3:1长期X3:2过渡期
X3:3短期X3:4中期
X4政策主体X4:1自治区人民政府办公厅X4:2卫生健康委员会
X4:3发展和改革委员会X4:4财政厅
X4:5教育厅X4:6民政厅
X4:7妇女儿童组织X4:8其他组织
X5政策受体X5:1政府部门X5:2患者
X5:3医疗机构X5:4保险机构
X5:5学校X5:6科研院所
X6政策工具X6:1供给型工具X6:2需求型工具
X6:3环境型工具
X7政策保障X7:1经费保障X7:2人员保障
X7:3设备保障X7:4技术保障
X7:5组织保障
X8政策监督X8:1事前监督X8:2事中监督
X8:3事后监督
X9政策领域X9:1宣传X9:2筛查
X9:3诊断X9:4干预
　X9:5关怀
), ArticleFig(id=1241759353024348975, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表2, caption=

地贫防治政策PMC模型变量设置

, figureFileSmall=null, figureFileBig=null, tableContent=
编号一级变量编号二级变量编号二级变量
X1政策性质X1:1描述X1:2方案
X1:3计划
X2政策功能X2:1明确权责X2:2规范引导
X2:3分类监管X2:4联动管理
X3政策时效X3:1长期X3:2过渡期
X3:3短期X3:4中期
X4政策主体X4:1自治区人民政府办公厅X4:2卫生健康委员会
X4:3发展和改革委员会X4:4财政厅
X4:5教育厅X4:6民政厅
X4:7妇女儿童组织X4:8其他组织
X5政策受体X5:1政府部门X5:2患者
X5:3医疗机构X5:4保险机构
X5:5学校X5:6科研院所
X6政策工具X6:1供给型工具X6:2需求型工具
X6:3环境型工具
X7政策保障X7:1经费保障X7:2人员保障
X7:3设备保障X7:4技术保障
X7:5组织保障
X8政策监督X8:1事前监督X8:2事中监督
X8:3事后监督
X9政策领域X9:1宣传X9:2筛查
X9:3诊断X9:4干预
　X9:5关怀
), ArticleFig(id=1241759353179538233, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Table 3, caption=

Distribution of Policy In struments in Policies

, figureFileSmall=null, figureFileBig=null, tableContent=
政策编号供给型需求型环境型合计
资金支持人才队伍防治服务科学研究设施设备政策知晓费用报销关心支持正常入学目标规划量化指标政策宣传观念引导行业规范
P13341310041131091163
P20140000003201314
P33315127181119671185
P41060160204164536
P581711331010823856
P63272533216632449
P71172420207223639
P826151731836345973
P910421115100020125417110
P102132123101112222
P115050014301213631
P123020012301112218
合计412296112543273468357403774596
), ArticleFig(id=1241759353343116102, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表3, caption=

政策工具政策分布情况表

, figureFileSmall=null, figureFileBig=null, tableContent=
政策编号供给型需求型环境型合计
资金支持人才队伍防治服务科学研究设施设备政策知晓费用报销关心支持正常入学目标规划量化指标政策宣传观念引导行业规范
P13341310041131091163
P20140000003201314
P33315127181119671185
P41060160204164536
P581711331010823856
P63272533216632449
P71172420207223639
P826151731836345973
P910421115100020125417110
P102132123101112222
P115050014301213631
P123020012301112218
合计412296112543273468357403774596
), ArticleFig(id=1241759353498305367, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Table 4, caption=

Two-Dimensional Cross-Analysis of Thalassemia Prevention and Control Policy Instruments and Stakeholders

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利益相关者供给型需求型环境型
政府部门764680
医疗机构916096
患者664370
保险机构201518
科研院所12210
社会大众353442
社会组织91011
学校121415
合计321224342
), ArticleFig(id=1241759353699631975, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表4, caption=

地贫防治政策工具－利益相关者二维交叉分析

, figureFileSmall=null, figureFileBig=null, tableContent=
利益相关者供给型需求型环境型
政府部门764680
医疗机构916096
患者664370
保险机构201518
科研院所12210
社会大众353442
社会组织91011
学校121415
合计321224342
), ArticleFig(id=1241759353976456063, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Table 5, caption=

Two-Dimensional Cross-Analysis of Thalassemia Prevention and Control Policy Instruments and Stakeholders

, figureFileSmall=null, figureFileBig=null, tableContent=
类型工具政府部门医疗机构患者科研院所保险机构学校社会大众社会组织合计
供给型资金支持3632201190135126
人才队伍122063121045
防治服务709470101612379318
科学研究59310101029
设施设备1321116022055
需求型政策知晓2432241111224119
费用报销232415113014595
关心支持2327211510177111
正常入学2420041013
环境型目标规划476436793171184
量化指标304126372130122
政策宣传2029230112224111
观念引导192923148186108
行业规范5070465155176214
合计57674350573145112306772 537
), ArticleFig(id=1241759355549320076, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表5, caption=

地贫防治政策工具－利益相关者二维交叉分析

, figureFileSmall=null, figureFileBig=null, tableContent=
类型工具政府部门医疗机构患者科研院所保险机构学校社会大众社会组织合计
供给型资金支持3632201190135126
人才队伍122063121045
防治服务709470101612379318
科学研究59310101029
设施设备1321116022055
需求型政策知晓2432241111224119
费用报销232415113014595
关心支持2327211510177111
正常入学2420041013
环境型目标规划476436793171184
量化指标304126372130122
政策宣传2029230112224111
观念引导192923148186108
行业规范5070465155176214
合计57674350573145112306772 537
), ArticleFig(id=1241759355721286553, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Table 6, caption=

Policy Scoring Grades

, figureFileSmall=null, figureFileBig=null, tableContent=
得分0~4.995~6.997~8.999~10
评价不良良好优秀完美
), ArticleFig(id=1241759355989722030, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表6, caption=

政策评分等级

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得分0~4.995~6.997~8.999~10
评价不良良好优秀完美
), ArticleFig(id=1241759356161688510, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=EN, label=Table 7, caption=

PMC Index Score of Policies

, figureFileSmall=null, figureFileBig=null, tableContent=
变量P1P2P3P4P5P6P7P8P9P10P11P12均值
X1政策性质0.670.331.001.000.330.330.670.330.330.330.330.330.50
X2政策功能1.000.501.000.500.501.000.750.751.001.001.001.000.83
X3政策时效1.000.500.250.250.250.750.250.250.250.250.250.250.38
X4政策主体0.880.131.000.130.130.880.130.130.500.380.630.500.45
X5政策受体0.500.500.670.330.501.000.671.000.670.830.830.830.69
X6政策工具1.000.671.001.001.001.001.001.001.001.001.001.000.97
X7政策保障1.000.801.001.001.001.001.001.001.001.000.400.400.88
X8政策监督1.001.001.001.001.001.001.000.671.000.670.671.000.92
X9政策领域1.000.601.000.800.801.001.001.001.001.000.800.400.87
PMC指数8.045.037.926.015.517.966.466.136.756.465.915.716.49
政策评价等级优秀良好优秀良好良好优秀良好良好良好良好良好良好良好
), ArticleFig(id=1241759356367209422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759327384567812, language=CN, label=表7, caption=

政策PMC指数得分表

, figureFileSmall=null, figureFileBig=null, tableContent=
变量P1P2P3P4P5P6P7P8P9P10P11P12均值
X1政策性质0.670.331.001.000.330.330.670.330.330.330.330.330.50
X2政策功能1.000.501.000.500.501.000.750.751.001.001.001.000.83
X3政策时效1.000.500.250.250.250.750.250.250.250.250.250.250.38
X4政策主体0.880.131.000.130.130.880.130.130.500.380.630.500.45
X5政策受体0.500.500.670.330.501.000.671.000.670.830.830.830.69
X6政策工具1.000.671.001.001.001.001.001.001.001.001.001.000.97
X7政策保障1.000.801.001.001.001.001.001.001.001.000.400.400.88
X8政策监督1.001.001.001.001.001.001.000.671.000.670.671.000.92
X9政策领域1.000.601.000.800.801.001.001.001.001.000.800.400.87
PMC指数8.045.037.926.015.517.966.466.136.756.465.915.716.49
政策评价等级优秀良好优秀良好良好优秀良好良好良好良好良好良好良好
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基于PMC指数模型的广西地中海贫血防治政策量化评价
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魏海斌 1, 2, 4 , 梁爽 2 , 韦俞伽 2 , 涂斯婧 2 , 何升 3 , 陈碧艳 3 , 李忠友 2
现代预防医学 | 卫生政策与管理 2024,51(18): 3368-3373
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现代预防医学 | 卫生政策与管理 2024, 51(18): 3368-3373
基于PMC指数模型的广西地中海贫血防治政策量化评价
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魏海斌1, 2, 4, 梁爽2, 韦俞伽2, 涂斯婧2, 何升3, 陈碧艳3, 李忠友2
作者信息
  • 1.广西大学公共管理学院，广西 南宁 530004
  • 2.广西中医药大学公共卫生与管理学院
  • 3.广西壮族自治区妇幼保健院
  • 4.广西中医药科技成果转化与应用协同创新中心

    • 魏海斌（1990—），男，博士在读，研究方向：卫生政策与健康不平等治理

通讯作者:

李忠友，E-mail：
Quantitative evaluation of Guangxi thalassemia prevention and control policies based on PMC index model
Hai-bin WEI1, 2, 4, Shuang LIANG2, Yu-jia WEI2, Si-jing TU2, Sheng HE3, Bi-yan CHEN3, Zhong-you LI2
Affiliations
  • School of Public Administration, Guangxi University, Nanning, Guangxi 530004, China
出版时间: 2024-09-25 doi: 10.20043/j.cnki.MPM.202405199
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摘要
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目的

分析评价地中海贫血防治政策、发现其政策工具使用与分布情况以及政策优缺点，提出改进建议。

方法

基于政策工具的视角，构建了“政策工具-利益相关者”的分析框架、借助政策一致性指数模型（Policy Modeling Consistency，PMC），进行定量评价。

结果

研究发现：广西地中海贫血防治政策总体质量较高，但也存在着多部门联合发文较少，缺乏需求型政策工具运用（18.46%），政策性质略显模糊，政策时效难以做到长期与短期兼顾等问题。

结论

地中海贫血防治政策应从增加需求型工具利用、兼顾政策长短期时效、动员多主体参与等方面入手提升政策质量。

地中海贫血防治政策  /  政策工具  /  内容分析  /  PMC指数模型
Objective

To analyze and evaluate the prevention and control policies for thalassemia, identify the usage and distribution of policy tools, as well as the advantages and disadvantages of the policies, and propose improvement suggestions.

Methods

From the perspective of policy instruments, an analytical framework of "policy tools-stakeholders" has been constructed. Utilizing the Policy Modeling Consistency (PMC) index model, a quantitative evaluation was conducted. The characteristics of policy tool usage were identified, problems in the policies were discovered, and strategies for policy optimization were explored.

Results

The study found that the overall quality of Guangxi’s thalassemia prevention and control policies is relatively high, but there are also issues such as fewer joint documents issued by multiple departments, lack of demand-oriented policy tools (18.46%), slightly vague policy nature, and difficulty in balancing long-term and short-term policy effectiveness.

Conclusion

The prevention and treatment policy for Mediterranean anemia should start by enhancing the utilization of demand-driven tools, taking into account the short-term and long-term effectiveness of the policy, and mobilizing the participation of multiple stakeholders to improve policy quality.

Thalassemia prevention and control policies  /  Policy tools  /  Content analysis  /  PMC index model
魏海斌, 梁爽, 韦俞伽, 涂斯婧, 何升, 陈碧艳, 李忠友. 基于PMC指数模型的广西地中海贫血防治政策量化评价. 现代预防医学, 2024 , 51 (18) : 3368 -3373 . DOI: 10.20043/j.cnki.MPM.202405199
Hai-bin WEI, Shuang LIANG, Yu-jia WEI, Si-jing TU, Sheng HE, Bi-yan CHEN, Zhong-you LI. Quantitative evaluation of Guangxi thalassemia prevention and control policies based on PMC index model[J]. Modern Preventive Medicine, 2024 , 51 (18) : 3368 -3373 . DOI: 10.20043/j.cnki.MPM.202405199
正文
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地中海贫血（以下简称“地贫”）是世界上最常见的遗传疾病之一[1]，广西地贫基因携带率约为20%[2]。同时，地贫发病率高，且目前无有效的根治方法[3]。地贫治疗费用昂贵，社会、家庭经济负担沉重[4]，地贫患者生存状况差[5]，心理健康也受到影响[6]。国外学者发现，一例重型地贫患者医疗卫生费用为284 154美元，劳动力损失和夭折的成本分别是51 843美元和141 944美元[7]。国内学者发现，一例中重型地贫患儿年直接经济负担为3 029 299.81元，年间接经济负担费用134 290.79元[8]。通过婚前检查、孕期筛查进行产前基因诊断，避免重型地贫患儿的出生就成为了目前国际公认的首选预防对策[9-11]。建立一个在政府主导下的规范严密的地贫预防筛查体系极为关键[2]，同时非政府组织也发挥着重要影响和积极作用[12]。自2010年5月《广西壮族自治区地中海贫血防治计划》颁布以来，逐步建立起“政府主导、部门联动、卫生担当、群众参与”的地贫防治工作机制。广西重型地贫胎儿出生率自2016年起呈逐年下降趋势（见图1），从2016年0.29/万下降至2022年的0.10/万，地贫患儿出生总人数从2016年45人下降至2022年4人，为地贫防治提供了示范。因此，有必要通过评估广西地贫防治政策质量，总结广西地贫防治经验。
1　资料与方法
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1.1　资料来源
从广西壮族自治区卫生健康委员会官方网站检索地中海贫血、出生缺陷等关键词，共收集整理出12份政策文件，见表1。具体信息分别包括颁布时间、颁布机构、文件名称、周期、类型以及对象。
1.2　研究工具和方法
1.2.1　构建分析框架
Ｘ维度借鉴Rothwell和Zegveld的分类思想[13]，将地贫防治政策工具分为供给型、环境型和需求型三类，将利益相关者划分为8种，以构建较为完整的“政策工具－利益相关者”二维分析框架。
1.2.2　PMC指数模型
PMC指数模型全称为Policy Modeling Consistency，在医疗卫生学界得到了广泛的关注与应用[14-17]。参照张文静等学者[18]对变量的设置，分别将地贫防治政策PMC模型变量设置为9个主要变量，各个主要变量下设置3~8个不等的次要变量（见表2）。
2　结果
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2.1　政策文本内容分析
2.1.1　政策工具总体状况分析结果
通过研读政策文本，将编码文本进行归类，共得到596个政策工具，其中供给型195个（32.72%）、需求型110个（18.46%）、环境型291个（48.82%），环境型政策工具使用数量最多、占比最大。政策工具在第12份文件编码频次最多为110次，占比20.95%；第2份文件编码频次最少为14次（见表3）。
2.1.2　单维度分析结果
政策工具维度。通过统计得到596个具体政策工具，其中291个为环境型政策工具，目标规划数量最多；供给型政策工具中防治服务数量最多；需求型政策工具总体数量最少，其中主要在集中在政策知晓和关心支持（见图2）。同时，还可以看出关心支持互动频次最少（见图2）。
2.1.3　政策工具－利益相关者二维交互分析结果
利益相关者中各类型政策工具分布如表4、5所示。供给型政策工具所涉及的利益相关者中，医疗机构所占比例最高（28.34%），最低为社会组织（2.8%）。需求型政策工具中，主要涉及医疗机构和政府部门，分别占26.79%和20.54%，最低为科研院所（0.89%）。环境型政策工具与供给型结果类似。具体而言，地贫防治政策工具在不同利益相关者中使用利益相关维度。596个政策工具所涉及的利益相关者中，医疗机构为主要的利益相关者（见图3）。同时，还可以看出社会组织产生了2次互动，互动频次最少（见图3）。
存在结构性特征。环境型政策工具使用频率最高，达到了38.56%，主要体现在目标规划和行业规范；最少为需求性政策工具，占比为25.25%，主要体现在政策知晓。
2.2　政策文本PMC指数模型评价结果
PMC指数模型的计算步骤为：①计算次要变量的值。所有次要变量都可以取1或0。如果内容涉及次要变量，则取1，否则取0。②计算所有主要变量的得分。主要变量得分是次要变量总分与其个数的比值，即计算次要变量的算术平均值。③汇总所有主要变量的得分，以获得PMC指数值。PMC指数得分可分为四个等级（见表6），本次筛选的12份地贫防治政策得分与评级情况（见表7）：P1等3项政策为优秀，其他为良好；其中，P1指数得分最高，为8.04分；P2指数得分最低，均为6.49分。
3　讨论
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3.1　高质量地贫防治政策优点
P1、P3、P6是12份地贫防治政策等级优秀的3项政策，PMC指数分别为8.04、7.92、7.96。在3项优秀政策的9个主要变量得分中，除了P3的X3政策时效和P6的X1政策性质比均值低，其余皆高于均值。这说明P1是最佳文件，高质量政策具有政策性质明确、政策功能全面、政策时效较长、政策工具充分等优点。
3.2　质量较低地贫防治政策缺点
单维度分析结果显示，地贫之家等社会组织在地贫防治往往过程中扮演着重要角色，但文件涉及较少。同时，收集到的广西地区12份地贫防治政策等级在优秀、良好范围内，政策受体全面涉及，总体水平较高。9个主要变量中，X6政策工具（0.96）、X7政策保障（0.98）、X8政策监督（0.96）、X9政策领域（0.91）这四个变量的均值较高，说明所选的12份政策能够灵活运用供给型工具、环境型工具、需求型工具三大类政策工具。涉及全部环节。X1政策性质（0.50）、X3政策时效（0.38）、X4政策主体（0.45）这三个变量的均值较低，质量较低政策存在政策性质模糊、政策时效难以做到长期与短期兼顾、政策主体难以联合的问题。
3.3　地贫防治政策改进方向
亟待出台充分应用需求型政策工具、体现人文关怀的政策文件。单维度分析结果显示，需求型政策工具总体数量最少，且关心支持互动次数最少，这与政策工具－利益相关者二维交互分析结果保持一致。此外，政策文本PMC指数模型评价结果也显示出，12份地贫防治政策中P2PMC指数最低，这主要是由于X4政策主体单一，X5政策受体狭窄，X6政策工具缺乏需求型工具运用，X9政策领域不健全造成的。其中，相较于政策知晓的需求型工具，费用报销和正常入学需要政府予以增加，此外刚性的政策规定还需要加以人文关怀，关心支持的政策工具同样需要增加。
4　结论与建议
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综上所述，地中海贫血防治政策质量总体较高，充分体现了政府对于地贫防治的重视程度，同时也反映了取得地贫防治效果的政策价值。根据研究结果提出如下建议：一是在总体充分运用供给型工具、环境型工具、需求型工具三大类政策工具的基础上，加大对需求侧的重视，政策的制定应当以地中海贫血患者的需求为导向；二是综合兼顾政策的长期效应、短期效应、中期效应以及过渡期效应，保持政策的可持续性和连贯性，避免出现政策空窗期；三是地贫防治是一项系统工程，需要积极动员自治区其他相关系统、部门联合参与进来，加大联合发文的执行力度；四是健全地贫防治的各个链条和环节，避免出现政策盲区；五是充分考虑各类利益相关者利益，减小政策阻力。
基金
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  • 广西壮族自治区卫生健康委横向课题(H202208)
  • 2022年广西高校中青年教师科研基础能力提升项目(2022KY0266)
  • 广西中医药大学高层次公共卫生人才培育创新团队资助项目(2022A009)
  • 广西中医药大学桂派杏林拔尖人才项目(2022C010)
文献
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2024年第51卷第18期
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文章信息
doi: 10.20043/j.cnki.MPM.202405199
  • 接收时间：2024-05-14
  • 首发时间：2026-03-20
  • 出版时间：2024-09-25
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出版历史
  • 收稿日期：2024-05-14
基金
广西壮族自治区卫生健康委横向课题(H202208)
2022年广西高校中青年教师科研基础能力提升项目(2022KY0266)
广西中医药大学高层次公共卫生人才培育创新团队资助项目(2022A009)
广西中医药大学桂派杏林拔尖人才项目(2022C010)
作者信息
    1.广西大学公共管理学院，广西 南宁 530004
    2.广西中医药大学公共卫生与管理学院
    3.广西壮族自治区妇幼保健院
    4.广西中医药科技成果转化与应用协同创新中心

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李忠友，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
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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