倡议联盟框架视角下我国医务人员执业安全的政策变迁分析

Analysis of policy changes in the safety of medical practice of medical staff in China based on the perspective of advocacy coalition framework

政策倡议联盟将政策变迁视为政策联盟和外部事件、政策取向学习共同作用的结果。本文运用这一框架理论分析建国以来的我国医务人员执业安全政策的变迁,证明了倡议联盟框架在分析中国的政策过程中同样适用。政策变迁的动力源于原有制度与社会、经济形势不匹配所造成的发展瓶颈。中国医务人员执业安全政策与医疗秩序、医患关系等社会现象紧密相关,医患双方基于各自的信念系组成相应的联盟并提出政策倡议,促成医务人员执业安全的政策变迁。

The Advocacy Coalition Framework(ACF)viewed policy change as the result of a combination of policy coalitions and external events and policy orientation learning.This paper applied ACF to analyze the changes of the practice safety policy of medical personnel since the foundation of PRC.This paper demonstrated that ACF was applicable to policy process in China.The driving force of policy change stems from the development bottleneck caused by the mismatch between the original system and the social and economic situation.Medical practice safety policy was closely related to social phenomena such as medical order and doctor-patient relationship.Doctors and patients have formed coalitions based on their beliefs,leading to the policy changes in medical practice safety.