基于社会网络分析和多维尺度分析的县域医共体医防融合研究

Research on medical and prevention integration of county medical consumption linkage based on social network analysis and multidimensional scale analysis

目的:梳理县域医共体医防融合领域研究现状与主题,分析其发展趋势,为相关研究及政策制定提供科学的参考依据。方法:以关键词“县域医共体”“医防融合”等为检索词,检索中国知网数据库2012年1月1日~2022年11月23日的文献;对关键词进行词频统计,采用Bicomb 2.0构建词篇矩阵和共现矩阵,SPSS 26.0进行聚类分析和多维尺度分析,Ucinet 6.0对共现矩阵进行社会网络分析。结果:共检索相关文献413篇,通过系统聚类分析,县域医共体医防融合研究主要包含医共体医院内部改革、医防融合医疗卫生服务运行载体研究、医联体分级诊疗举措以及医防融合具体实施措施4个聚类;通过多维尺度分析,研究可分为医院内部管理、签约服务与公共卫生服务融合、以慢病管理为核心的医防融合服务和宏观系统研究4个类团;通过社会网络分析,结果形成以“县域医共体”“医防融合”为核心的包含核心层和边缘层的双层网络结构。结论:县域医共体医防融合研究中机制与服务的融合是其核心内容;微观系统研究相对完善,宏观系统亟需加强;同时其服务网络连接紧密,管理、信息化网络联系松散。

Objective:To sort out the research status and research topics in the field of medical and preventive integration of county medical consumption linkage,analyze its development trend,and provide scientific references for relevant research and policy formulation.Methods:The keywords"county medical consumption linkage"and"medical prevention integration"were used as search terms to retrieve literature from January 1,2012,to November 23,2022,in the CNKI database;the keywords were counted for word frequency,and Bicomb 2.0 was used to construct the word-part matrix and cooccurrence matrix.SPSS 26.0 was used for cluster analysis and multidimensional scale analysis,and Ucinet 6.0 was used for social network analysis of the co-occurrence matrix.Results:A total of 413 relevant pieces of literature were retrieved.Through systematic cluster analysis,the research on the integration of medical and prevention in the county medical consumption linkage mainly includes four clusters:internal reform of medical consumption linkage hospitals,research on the operating carrier of medical and prevention integrated medical and health services,the hierarchical medical system and treatment measures of medical consortium and specific implementation measures of medical and prevention integration.Through multidimensional scale analysis,the research can be divided into four groups:internal management of hospitals,integration of contracted services and public health services,integration of medical and preventive services with chronic disease management as the core,and macro-system research.Through social network analysis,the results form a two-layer network structure including a core layer and edge layer with‘county medical consumption linkage'and‘medical prevention integration'as the core.Conclusion:The integration of mechanism and service is the core content in the research of medical prevention integration of the county medical consumption linkage.The micro-system research is relatively well studied,but the macro-system needs to be strengthened.At the same time,its service network is closely connected,and the management and information network are loosely connected.