基于内容分析法的部分典型国家卫生规划政策研究

Study on national health planning of several typical countries based on content analysis method

目的:基于内容分析法分析当前世界各国卫生规划关注的热点领域,并通过比较研究揭示其中的共性和差异,为我国的卫生规划提供借鉴。方法:基于WHO Country Planning Cycle Database,筛选时间跨度覆盖2019年及以后且语言为英文的国家卫生政策战略,选取其中15个国家的规划文件,提取相关关键词,运用UCINET6软件计算点度中心度。结果:各国规划文件的关键词可归为基本理念、体制机制、卫生资源、卫生服务、健康相关因素和效果评估6个分析维度。发达国家卫生规划基本理念维度以及“循证政策制定”、“服务质量”和“可及性”的点度中心度较高;发展中国家卫生规划健康相关因素维度、卫生资源维度关键词点度中心度较高。结论:“健康”和“整合”的理念受到各国关注,评估是较被忽视的环节。发达国家的卫生规划更倾向于对主旨和基本理念的把控,强调基于循证理念的政策制定;发展中国家更注重合作,通过资源合理配置保障服务提供,减轻疾病负担。我国卫生规划兼具发达和发展中国家的特点,后期需重视循证支持,构建更整合的医疗卫生体系,重视规划实施的评估和反馈。

Objective:To analyzethe hot areas and trends of current health planning policies around the world based on content analysis method,andreveal the differences in contents of the planning between countries,so as to provide reference for health planning and health development direction.Methods:Based on the WHO Country Planning Cycle Database,15 Planning documents were chosen,from whichkeywords were screened,and thedegree centralitywas calculatedusing UCINET 6.Results:Keywords of planning documents couldbe classified into six analytical dimensions including fundamental philosophy,system and mechanism,health resources,health services,health-related factors and effect appraisal.High frequency keywords in documents of countries with different levels of development wereboth similar and different;whereby thedegree centrality of the basic concept and service dimension was found to be relatively high in developed countries,while the degree centrality of keywords of health-related factors andhealth resources dimension washigher in developing countries.Conclusions:The concept of“health”and“integration”has always got moreattention from all countries.Health planning in developed countries tends to focusmore about substance and basic beliefs,with an emphasis on evidence-based policy-making.However,in developing countries,more attention is paid to cooperation,ensuring the provision of health services through input and rational allocation of health resources,and reducing the burden of diseases.Even though China has some characteristics of developed countries,its health planning mainly reflects the characteristics of developing countries.It is suggested that more attention should be paid to evidence-based support,a more integrated medical and health system should be built,and attention should be given to the evaluation and feedback of the health planning policies.