县域医共体改革如何提升突发公共卫生事件应对能力——基于浙江省的实证研究

How does the Reform of County Medical Community Improve the Capacity to Respond to Public Health Emergencies--An Empirical Study Based on Zhejiang Province

在“强基层”战略推动下,县域医共体建设已经成为提升基层医疗卫生服务能力的关键抓手。突如其来的公共卫生危机构成了新的挑战,如何在时间高度紧迫、医疗需求骤增的情境下实现有效应对,成为实务部门和学术界共同关注的焦点问题。本文从整体性治理视角出发,聚焦整体性协同与组织重新整合两项核心元素,以浙江省县域医共体改革为研究对象,考察这一改革对突发公共卫生事件应对能力的影响,并通过案例分析阐释其中的作用机制。研究结果显示,县域医共体改革能够显著提升基层的应对能力,改革的完成情况与防范预警、医疗救治两个应对阶段的表现紧密相关,能力提升通过多元主体协同联动机制与需求驱动的资源统筹机制予以实现。

Driven by the strategy of“enhancing the grassroots”,the construction of the county medical community has become the key to improving the primary healthcare service capacity.The sudden public health emergency has posed a new challenge.Effectively responding in the context of time constraints and sudden increases in demands for medical care has become the focus of common concern of practical departments and academia.From the perspective of holistic governance,this paper focuses on the two core theoretical elements of holistic coordination and organizational re-integration.Taking the reform of county medical community in Zhejiang Province as the research object,this study empirically analyzed the impact of reform on the capacity to cope with public health emergencies,and explains the mechanism of reform through case analysis.The results show that the reform can significantly improve the coping capacity of the grassroots.The completion of the reform is closely related to the performance of the two coping stages:early warning of the risk and medical treatment.Capacity improvement can be achieved by relying on the multi-subject collaborative linkage mechanism and the demand-driven resource coordination mechanism,respectively.