组态视角下卫生健康服务体系建设发展路径研究

Research on the path of development and construction of healthcare service system from the configurational perspective

[目的]研究卫生健康服务体系建设的影响因素,探究多元结构要素组合对我国健康卫生服务建设发展的推进作用,为我国卫生健康服务体系的建设提供理论参考,并为各项任务的落实提供实践指导。[方法]基于TOE“技术-组织-环境”理论框架,对《2021年和2022年中国卫生健康服务体系创新案例集》中38个典型案例进行清晰集定性比较分析(csQCA),探究我国卫生健康服务建设发展的影响因素及实现路径。[结果]通过对数字赋能、推动主体、多方协同、医疗保障、管理体制、所在区域6个结构要素进行必要性检验,发现数字赋能和多方协同为核心条件,分析得到卫生健康服务建设存在9条驱动路径,可将其归纳成组织主导型、组织-环境型、技术-组织型、技术-组织-环境型4类发展路径。[结论]我国卫生健康服务建设过程中的“数字赋能”可以作为卫生健康服务建设的必要条件,多方协同是实现卫生健康服务体系建设的核心要素。

Objective This paper studies the influencing factors of the construction of healthcare service system and explores the role of the combination of multiple structural elements in promoting the construction and development of healthcare services in China,to provide the theoretical reference for the construction of healthcare service system in China,and to provide practical guidances for the implementation of various tasks.Methods Based on the TOE theoretical framework of“technology-organization-environment”,a crisp-set qualitative comparative analysis(csQCA)was conducted on 38 typical cases in the 2021 and 2022 China Health Service System Innovation Case Collection,to explore the influencing factors and paths of the construction and development of healthcare services.Results Through the necessity test of six structural elements of digital empowerment,promotion subject,multi-party collaboration,medical security,management system,and local region,it was found that digital empowerment and multi-party collaboration were the core conditions.According to the analysis,there were nine driving paths for the construction of healthcare services,which were summarized into four development paths:organization-oriented path,organization-environment path,technology-organization path,and technology-organization-environment path.Conclusions“Digital empowerment”in the construction of healthcare services in China can be used as a necessary condition for the construction of healthcare services.Multi-party collaboration is the core element to realize the construction of healthcare service system.