基层医疗卫生机构发展的制约因素及对策研究——基于扎根理论视角
|
摘要
目的:应用扎根理论的方法,探讨基层医疗卫生机构发展的制约因素,为促进基层卫生综合改革提供政策建议。方法:利用2017年度贵州省基层卫生管理人员培训班进行主题互动交流,经开放式编码、主轴编码、选择性编码,对基层医疗卫生机构发展的制约因素进行逻辑提取、归纳与分析。结果:制约基层医疗卫生机构发展的因素主要包括政策阻碍因素、资源配置因素、职能影响因素。结论:新医改为基层医疗卫生机构发展带来了机遇,但面临的挑战更加艰巨,还需进行科学的政策调整,优化资源配置,明确基层医疗机构职能定位,推进基层医疗卫生机构可持续发展。
Objective To explore the constraints of the development of primary health care institutions and provide policy recommendations for promoting comprehensive reform of primary health based on grounded theory. Methods Using the 2017 Guizhou Provincial Grassroots Health Management Training Course to carry out thematic interaction and exchange. Open coding,spindle coding,selective coding were applied to extract logically,induct,and analyze the constraints of the development of primary health care institutions. Results The factors restricting the development of primary health care institutions mainly included policy impediments,resource allocation factors,and functional influence factors. Conclusion The change of new medical treatment to grassroots medical and health institutions has brought opportunities,but the challenges were even more arduous. It is necessary to carry out scientific policy adjustments,optimize resource allocation,clarify the functional orientation of primary medical institutions,and promote the sustainable development of primary health care institutions.
Objective To explore the constraints of the development of primary health care institutions and provide policy recommendations for promoting comprehensive reform of primary health based on grounded theory. Methods Using the 2017 Guizhou Provincial Grassroots Health Management Training Course to carry out thematic interaction and exchange. Open coding,spindle coding,selective coding were applied to extract logically,induct,and analyze the constraints of the development of primary health care institutions. Results The factors restricting the development of primary health care institutions mainly included policy impediments,resource allocation factors,and functional influence factors. Conclusion The change of new medical treatment to grassroots medical and health institutions has brought opportunities,but the challenges were even more arduous. It is necessary to carry out scientific policy adjustments,optimize resource allocation,clarify the functional orientation of primary medical institutions,and promote the sustainable development of primary health care institutions.
引文
[1]杨亚鹏.基层医疗卫生机构综合改革存在的问题及对策[J].西部财会, 2014(2):68-71.
[2]徐向峰,庞豪.农村基层医疗卫生服务存在问题与对策[J].人民论坛, 2015,29(4):156-158.
[3]李贺楼.扎根理论方法与国内公共管理研究[J].中国行政管理,2015,11(14):76-81.
[4]秦晓强,尹文强,黄冬梅,等.基于扎根理论的新医改背景下乡村医生发展研究[J].中国卫生政策研究,2016, 9(6):20-25.
[5]湖北省襄阳市财政局课题组.完善基层医疗卫生机构补偿机制问题研究[J].财政研究,2013(2):9-13.
[6]陈东升,吴天,王骞,等.某省基层医疗卫生机构运行发展现状及问题研究[J].卫生经济研究,2015(5):21-27.
[7]彭迎春,何永洁.北京市基层医疗卫生机构补偿机制存在的问题探折[J].医学与社会,2015,28(12):16-19,24.
[8]张丽芳,孙涛,张艳春,等.基层医疗卫生机构实施绩效工资的典型案例和问题分析[J].中国卫生经济,2016,35(9):70-72.
[9]赖丹,肖云昌,黄河浪,等.基层医疗卫生机构绩效考核实施现状及问题思考[J].现代医药卫生,2013,29(19):3023-3025.
[10]陈君.基层医疗卫生单位绩效工资改革中的问题与对策[J].卫生经济研究, 2014(8):47-48.
[11]郝亚,杨佳.我国乡镇卫生院绩效评价现状与改革思路[J].医学与社会,2014(7):5-9.
[12]朱晓丽,陈庆琨,杨顺心.新一轮医改以来我国基层卫生人力资源现状及问题分析[J].中国卫生政策研究,2015,8(11):57-62.
[2]徐向峰,庞豪.农村基层医疗卫生服务存在问题与对策[J].人民论坛, 2015,29(4):156-158.
[3]李贺楼.扎根理论方法与国内公共管理研究[J].中国行政管理,2015,11(14):76-81.
[4]秦晓强,尹文强,黄冬梅,等.基于扎根理论的新医改背景下乡村医生发展研究[J].中国卫生政策研究,2016, 9(6):20-25.
[5]湖北省襄阳市财政局课题组.完善基层医疗卫生机构补偿机制问题研究[J].财政研究,2013(2):9-13.
[6]陈东升,吴天,王骞,等.某省基层医疗卫生机构运行发展现状及问题研究[J].卫生经济研究,2015(5):21-27.
[7]彭迎春,何永洁.北京市基层医疗卫生机构补偿机制存在的问题探折[J].医学与社会,2015,28(12):16-19,24.
[8]张丽芳,孙涛,张艳春,等.基层医疗卫生机构实施绩效工资的典型案例和问题分析[J].中国卫生经济,2016,35(9):70-72.
[9]赖丹,肖云昌,黄河浪,等.基层医疗卫生机构绩效考核实施现状及问题思考[J].现代医药卫生,2013,29(19):3023-3025.
[10]陈君.基层医疗卫生单位绩效工资改革中的问题与对策[J].卫生经济研究, 2014(8):47-48.
[11]郝亚,杨佳.我国乡镇卫生院绩效评价现状与改革思路[J].医学与社会,2014(7):5-9.
[12]朱晓丽,陈庆琨,杨顺心.新一轮医改以来我国基层卫生人力资源现状及问题分析[J].中国卫生政策研究,2015,8(11):57-62.