政策工具与区域差异视角下我国公立医院财政补偿政策文本分析

Policy Text Analysis of Synergy of Traditional Chinese and Western Medicine Based on Policy Tools

目的分析2009—2023年我国公立医院财政补偿政策,旨在揭示政策发文特征,探讨不同区域在政策工具的使用上存在的问题,为政策优化提供建议。方法基于政策工具理论,构建政策工具-政策目标-经济区域三维分析框架,运用内容分析法对纳入的223份政策文本进行量化分析,得到有效编码3142条。结果政策发文量在时间上总体呈现“双峰”状;政策工具维度中供给型、环境型和需求型分别占比为50.00%、39.21%、10.79%;政策目标维度中完善相关制度占比最高(33.16%),补偿公共卫生服务使用最少(8.50%);经济区域维度东部地区发文量最多(94篇),东北地区发文量最少(12篇);4大地区政策工具均以供给型为主,在财政支持、政府购买等工具的使用上存在差异。结论相关部门应加强重视并积极创新地方政策;优化政策工具内外部结构,提升使用的均衡性;加强政策对补偿公共卫生服务目标的关注;进一步优化对中、西部地区的财政投入。

Objective To analyze the emphasis and deficiencies of synergy of traditional Chinese and Western medicine policy texts,and provide references for future policy development and optimization.Methods From the perspective of policy tools,a two-dimensional“policy objectives-policy tools”analysis framework was constructed,and 75 policy documents related to the synergy of traditional Chinese and Western medicine were quantitatively analyzed using content analysis.Results In the X-dimension,supply-oriented policy tools were used the most(48.18%),followed by demand-oriented tools(24.09%)and environment-oriented tools(27.72%),with a relatively small proportion of usage.Additionally,there were significant differences in the internal structure of each policy tool.In the Y-dimension,promoting the cultivation of synergy of traditional Chinese and Western medicine had the highest proportion(22.56%),while the goal of establishing a complete mechanism for preventing and controlling diseases through synergy of traditional Chinese and Western medicine had the lowest proportion(4.40%).Conclusion In the future,policies in the field of synergy of traditional Chinese and Western medicine should increase their emphasis on demand-oriented and environment-oriented tools,optimize policy tool combinations,and improve target layouts.Meanwhile,it should perfect the layout of policy objectives,provide necessary policy support for weak links,strengthen cooperation and communication among policy-making departments,and further promote the construction of a policy system for synergy of traditional Chinese and Western medicine.