深圳市高血压糖尿病门诊用药保障政策实施的影响因素及对策研究——基于扎根理论的质性研究

The influencing factors and countermeasures of the implementation of the security policy of Hypertension and Diabetes'outpatient medication in Shenzhen:A qualitative study based on Grounded Theory

目的:探讨深圳市高血压糖尿病门诊用药保障政策的实施现状及影响因素。方法:对65名利益相关者进行半结构化访谈,采用扎根理论研究方法提取、归纳政策实施的现状及影响因素。结果:构建影响政策实施的相关因素及其相互关系,形成了以“患者就诊偏好”、“两病政策的全面性”和“制度的横向和纵向协同”为核心的偏好—全面性—协同影响因素模型。结论:深圳市高血压糖尿病门诊用药保障政策有效促进了患者到基层就医,降低了患者疾病负担,但在满足不同患者的需求、政策覆盖面和医疗卫生系统内外部协同等方面的不足对当前政策继续发挥更大作用造成了一定程度的制约。

Objective:The implementation status and influencing factors of The Security Policy of Hypertension and Diabetes'Outpatient Medication in Shenzhen was explored.Methods:Semi-structured interviews were conducted toward totally 65 stakeholders,and the implementation status and influencing factors were extracted and summarized by Grounded Theory Analysis.Results:The interactions and the factors influencing the implementation of the policy were constructed.PSC model,comprised of“Patient Preference”,“Policy Comprehensiveness”and“Horizontal and Vertical Synergy”serving as the cores,was thereupon constructed.Conclusion:The policy has effectively promoted patients'primary care and reduced the burden of disease,but the deficiency in meeting patients'various needs,expanding the coverage of the policy and forming the internal and external coordination of the medical and health system have restricted the more profound impact that policy in the future.