摘要
目的:分析我国全科住院医师规范化培训政策工具使用的情况,找出目前政策制定时的侧重点与不平衡之处,为优化调整政策结构提供依据。方法:通过检索2009—2018年间与全科医生培养相关的政策文件,并对纳入的33篇文献进行编码后使用Excel2016进行分析。结果:2011年后关于全科住院医师规范化培训的政策文件数量呈现快速上升的趋势。其中,硬件与软件涉及最多,象征与劝诫型工具中舆论宣传提及最少。系统论维度中内部子模指标占全部指标的69.49%,外部子模占30.51%。结论:基本政策工具维度显示能力建设型政策工具与权威型政策工具使用较多,个别政策工具被忽略,基本政策工具维度分布不合理;系统论维度显示政策的内部子模与外部子模之间的分布不平衡,内部子模分布更广,外部子模中的社会系统响应次数最少。建议:重视激励型政策工具、象征与劝诫型政策工具的使用,全方位激励全科住院医师规范化培训学员;重视系统外部子模工具的使用,充分利用社会系统,营造良好全科执业环境。
Objective:To analyze the use of standardized training policy tools for general practitioners in order to find out the emphases and imbalance in the current policy making,providing the basis for optimizing and adjusting the policy structure.Methods:The policy documents related to the cultivation of general practitioners from 2009 to 2018 were researched,and 33 included literatures were encoded and analyzed using Excel 2016.Results:Among the 118 policy documents that were encoded,capacity-building tools featured more frequently,and the hardware and software were the most involved.Among the symbolic and exhortative tools,public opinion was mentioned at least.In the dimension of the system theory,the internal sub-model index accounted for 69.49%of all indexes,and 30.51%was taken by the external sub-model.Conclusions:The system theory dimension showed that there was a certain imbalance in the distribution between the two sub-models of the policy.The internal sub-model was more widely distributed,and the social system in the external sub-model was mentioned at least.Suggestions:More importance should be attached to the use of incentive policy tools,symbol and exhortation policy tools,and comprehensive motivation of trainees the use of sub-model tools outside the system should be given account.The social system should be made full use,and a good general practice environment should be created.
作者
刘伟楠
周稳
唐大龙
朱滨海
LIU Wei-nan;ZHOU Wen;TANG Da-long;ZHU Bin-hai(School of Health Policy&Management,Nanjing Medical University,Nanjing Jiangsu 211166,China;Department of Education,The first Affiliated Hospital of NanjingMedical University,Nanjing Jiangsu 210029,China)
出处
《中国卫生政策研究》
CSCD
北大核心
2019年第10期36-41,共6页
Chinese Journal of Health Policy
基金
江苏省社会科学基金重点项目(16ZHA002)
江苏省卫生计生委住培管理课题(G2016003)
关键词
全科医生
全科住院医师
规范化培训
政策工具
General practitioner
General resident practitioner
Standardized training
Policy tools
