摘要
[目的]分析湖北省县域医共体在新型冠状病毒肺炎疫情防治中发挥的作用与面临的挑战,为完善与健全县域医共体突发公共卫生事件应急综合防治模式提供决策与参考。[方法]采用目的抽样法,调研湖北省4个典型地区的县域医共体,与知情人员进行半结构化访谈。基于质性研究中的扎根理论,运用NVivo 11软件对访谈材料进行编码分析。[结果]经过三级编码,梳理出50个初始概念,16个范畴,7个主范畴和1个核心范畴,在此基础上构建了县域医共体疫情防治发挥作用的层次关系图,该理论图由3个层次(微观层面:内部分级防控,有效应对;中观层面:整体调度,高效协作;宏观层面:与外部协同,共同作战)和5大要素(人、财、物、信息、技术)组成。[结论]新冠疫情疫情期间,县域医共体初步形成了应急综合防治模式,但也面临着一些挑战,应首先解决基层医护人员专业素养低及基层医疗卫生机构基础设施不完善这两方面“突出”和“迫切”问题;同时提高龙头医院的诊治能力,解决发展瓶颈;最后,要紧紧抓住信息化建设“利器”,发挥其在应急防治中的优势,从而完善县域医共体在突发性公共卫生事件中的综合防治模式。
Objective To analyze the role and challenges of county-level medical alliance in the COVID-19 epidemic prevention and control in Hubei province so as to provide decision and reference for improving and perfecting the comprehensive prevention and control model of county-level medical alliance in public health emergencies.Methods Objective sampling method was used to investigate 4 typical county-level medical alliances in Hubei Province,and semi-structured interviews with relevant insiders were conducted.Based on the grounded theory in qualitative research,Nvivo11 software was used to conduct coding analysis on the interview materials.Results After three-grade coding,50 initial concepts,16 categories,7 main categories and 1 core category were sorted out.On this basis,a hierarchical relationship diagram of the role of epidemic prevention and control in county-level medical alliance was constructed.The theoretical diagram was composed of 3 levels(Micro level included internal hierarchical prevention and control,effective response;Middle level included overall scheduling,efficient collaboration;Macro level included cooperation with outside and fighting together)and 5 elements(human,financial,material,information,technology).Conclusions During the period of COVID-19 outbreak,the county-level medical alliance initially formed an emergency comprehensive prevention and control model.However,there are also some challenges.First of all,the“outstanding”and“urgent”problems of low professional quality of primary medical staff and imperfect infrastructure of primary medical and health institutions should be solved.At the same time,improve the diagnosis and treatment ability of leading hospital to solve the bottleneck of development;Finally,it is necessary to seize the information construction as a“weapon”,give play to its advantages in emergency prevention and control,so as to improve the comprehensive prevention and control model of county-level medical alliance in public health emergency.
作者
谢平茹
陈超亿
付谦
邹伟能
冯占春
XIE Ping-ru;CHEN Chao-yi;FU Qian;ZOU Wei-neng;FENG Zhan-chun(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430030,China;Hubei Key Research Base for Humanities&Social Sciences--Research Center for Rural Health Service,Wuhan Hubei 430030,China)
出处
《卫生软科学》
2022年第1期26-31,共6页
Soft Science of Health
基金
国家自然科学基金项目-信息技术驱动的突发公共卫生事件应急能力建设模式研究(72074088)
国家卫生健康委基层健康司委托纵向课题-县域医共体在新冠肺炎防治中发挥作用与影响研究。
关键词
县域医共体
扎根理论
突发性公共卫生事件
综合防治模式
county-level medical alliance
grounded theory
public health emergency
comprehensive prevention and control model
