医疗卫生行业综合监管制度体系构建——基于扎根理论的质性分析

Construction of the comprehensive regulatory system for the health care industry:Qualitative analysis based on the grounded theory

目的:运用扎根理论方法研究医疗卫生行业综合监管制度体系框架并提出相应对策,为完善医疗卫生行业综合监管制度提供科学依据。方法:2018年9—12月对北京市各级卫生行政部门、卫生监督机构以及医疗机构、相关行业协会负责人、领域内专家、高校教师共计27人进行访谈,结合文献资料和小组研讨等内容,采用三级编码将原始资料逐级浓缩并分类、归纳。结果:经过三级编码提炼出42个初始范畴、11个主范畴及5个核心范畴,最终形成综合监管制度体系框架,应构建“四位一体”相互协作的综合监管格局,建立信息平台实现技术上的严密管控,同时完善定期督察机制和法律法规的制定。结论:实施医疗卫生行业综合监管必须坚持政府主导,完善多元主体协调机制,创新监管机制、完善保障制度,构建科学合理的综合监管体系。

Objective:Based on the grounded theory method,this research was conducted to study the framework of the comprehensive regulatory system for the health care industry and to put forward the corresponding countermeasures,so as to provide a scientific basis for the reform and improvement of the comprehensive regulatory system of the health care industry.Methods:Interviews were conducted among 27 experts from all levels of health administrative departments,health supervision institutions,medical institutions,and relevant industry associations,experts in the field and university teachers in Beijing during the period from September to December 2018.Combined with literature and group discussion,the original data were condensed,classified and summarized level by level through three-level coding.Results:A total of 42 initial categories,11 main categories and 5 core categories were refined through the three-level coding,and the framework of comprehensive regulatory system was finally formed.A"four in one"comprehensive regulatory pattern with mutual cooperation should be constructed,an information platform should be established to achieve strict technical control while improving the regular supervision/inspection mechanism and the formulation of laws and regulations.Conclusions:The implementation of comprehensive regulatory system of health care industry should adhere to the government's leadership,the coordination mechanism of multiple subjects should be improved,the supervision mechanism should be innovated and enhanced,the security system should be improved,and a scientific and reasonable comprehensive regulatory system should be constructed.