我国医防协同政策文本量化分析——基于政策工具、协同层次和协同机制的三维框架

Objective: The paper analyzed the focus and deficiency of China’s medical and prevention coordination policies, so as to provide reference for optimizing medical and prevention coordination policy. Methods: A three-dimensional framework of basic policy tools, coordination levels and coordination mechanisms was constructed. Searching the relevant policy texts of medical and prevention coordination at the national level from 2009 to 2021, and multi-dimensional classification analysis the retrieved policy texts by using content analysis methods and policy documents quantitative analysis methods. Results: Among the 20 policies, supply, environment and demand policy tools accounted for 58.62%、33.33% and 8.05%, respectively. The service coordination items were the most (51.43%), followed by professional coordination (27.14%) and system coordination (21.43%). The division of labor and cooperation mechanism accounted for the highest proportion (55.68%), and there was no medical insurance financing payment mechanism involved in policies. Conclusion: Lack of top-level design, imbalanced application of policy tools, unreasonable coordination levels and imperfect coordination mechanisms. It was necessary to accelerate the top-level design of medical and prevention coordination policies, optimize the use structure of policy tools, improve multi-level medical and prevention coordination policies, and accelerate the improvement of diversified medical and prevention coordination mechanisms.