远程医疗政策执行效果的关键影响因素识别研究——基于模糊DANP法

Research on identification of key influencing factors of telemedicine policies implementation effect:Based on fuzzy DANP methodology

目的:探讨远程医疗政策执行效果的关键影响因素,在理论上丰富评价远程医疗政策执行效果的指标体系,在实践中为提升远程医疗政策的执行效果提供有益参考。方法:首先以米特—霍恩模型为分析框架,通过文献研究法,构建了由5个一级因素和15个二级因素组成的远程医疗政策执行效果影响因素体系;然后在专家打分的基础上,运用模糊DEMATEL法计算出各影响因素的中心度和原因度,绘制因果关系图,并利用ANP法确定各因素的权重;最后,结合因素的因果关系和权重两方面来识别与分析关键影响因素。结果:可操作性、服务监督机制、政策认知、政策回应、执行方式、配置模式、激励约束手段等是最主要的二级因素。建议:以政策目标和资源为导向,建立健全远程医疗政策法规体系;加强统筹协调,积极推动远程医疗服务发展;加强宣传沟通,扩大远程医疗政策影响面。

Objective:To enrich the index system for evaluating the implementation effect of telemedicine policy in theory and provide a beneficial reference for improving the implementation effect of telemedicine policy in practice by discussing the key influencing factors of the implementation effect of telemedicine policies.Methods:Firstly,a system of influencing factors which was composed of 5 primary factors and 15 secondary factors for the implementation effect of telemedicine policies was established through literature research method based on the Meter-Horn model for analysis framework.Then,the fuzzy DEMATEL method was used to calculate the centrality and cause degree of each influencing factor based on expert scoring,draw the causality diagram,and determine the weight of each factor by the ANP method.Finally,the key influencing factors are identified and analyzed by combining the causal relationship and weight of factors.Results:Operability,service supervision mechanism,policy cognition,policy response,implement way,configuration mode,incentive and constraint means are the most important secondary factors.Suggestions:(1)Establish and improve the policy and regulation system of telemedicine based on policy objectives and resources;(2)Strengthen overall planning and coordination,and actively promote the development of telemedicine services;(3)Strengthen publicity and communication and expand the influence of telemedicine policies.