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Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.
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OBJECTIVE To sort out reform policy for basic medical insurance designated retail pharmacy （referred to as designated retail pharmacy） in China， and to provide reference for the improvement of the policy under the new situation of mutual- aid mechanism for covering outpatient bills. METHODS The policy texts on designated retail pharmacies issued by ministries and commissions of the State Council and departments directly under the State Council were collected from December 1998 to June 2023. The content analysis and social network analysis were adopted to construct a three-dimensional analytical framework based on the policy subject， the policy tool， and the policy process， in order to quantitatively analyze the policies on reforming designated retail pharmacies. RESULTS & CONCLUSIONS The reform policy of designated retail pharmacies can be roughly divided into three stages： germination， exploration and development， and in-depth promotion. The use of policy tools is dominated by environment-oriented tools， and the cooperation network of policy subjects presents a “head-body-tail” chain structure. With the advancement of policy reforms， the number of policy subjects showed a trend of decline followed by growth， the number of policy documents showed an upward trend， emphasizing the use of tools such as the construction of the pharmacist system， the flow of prescriptions， the payment of medical insurance， and the management of “dual-channels” and “outpatient co-ordination”. It is suggested that in terms of policy formulation， all policy subjects should adhere to top-level design， grasp the characteristics of the stage of policy development， and adjust the use of policy tools according to local and timely conditions； we should also strengthen cooperation and communication， improve policy formulation efficiency， achieve policy coordination， and continuously improve policies for designated retail pharmacies.
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Purpose/Significance To analyze the characteristics and problems of the policy texts of hospital informatization in China,and to explore the methods of policy optimization.Method/Process Related policy documents of hospital informatization at the national level are re-trieved from March 17,2009 to August 31,2023,and the policy texts are coded and analyzed from two dimensions of policy tools and system theory.Result/Conclusion The policy of hospital informatization in China is mainly based on environment-oriented policy tools,and it is sug-gested to pay more attention to the use of demand-oriented and supply-oriented tools.In addition,it is necessary to scientifically optimize the internal structure of policy tools,strengthen the use of internal submodels,and improve the systematization of policy tools.
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Objective:To analyze the release and distribution characteristics of Chinese medical insurance payment policies,and to provide reference for future policy formulation in the field of medical insurance payment construction.Methods: Content analysis method was used to construct a two-dimensional framework of "policy goals-policy tools",and text analysis was carried out according to 63 policy documents.Results: A total of 493 policy codes were completed.From the perspective of policy goals,the policy objectives of Chinese medical insurance payment mainly focused on three aspects: improving the payment level,optimizing the medical insurance environment,and standardizing the supervision regulations.From the perspective of policy tools,environmental policy tools are the most used policy tools,followed by supply and demand tools.There is a shortage of financial input and talent training in all policy objectives,so more attention should be paid to demonstration and Category of payment.Conclusion: Our country puts forth effort to build a perfect medical insurance payment system,but should further strengthen policy content supplement,optimize the structure of policy tools,and give full play to the payment ability of medical insurance when pulling the demand of medical insurance payment and driving the supply of medical insurance payment.
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Objective:To analyze the key points and shortcomings of Traditional Chinese Medicine(TCM)science and technology innovation policy in China,and to provide reference for the subsequent policy optimization.Methods:Searching for TCM science and technology innovation policy texts released at the national level since 2007,and use the two-dimensional analysis framework for quantitative analysis.Results:Among 27 policies,In the X dimension,supply-based,environmental and demand-based policy tools respectively accounted for 48.98%,39.29%and 11.73%.In the Y dimension,the proportion of scientific and technological innovation and achievement transformation was the highest(29.03%);Promoting the development of integrated Chinese and Western medicine was the least used(1.08%).Conclusion:There is a structural imbalance in the application of policy tools,the distribution difference of policy objectives is significant,and the internal policy tools'usage is imbalanced regarding policy objectives.Suggestions:Optimize the internal structure of policy tools.Meanwhile,enhance the structure of policy objectives,and facilitate the dynamic integration and application of policy tools to achieve the policy objectives of scientific and technological innovation in TCM.
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Objective:To sort out medical device related policies in Anhui Province,to analyze the distribution of content in each policy text to provide reference for policy optimization in the later stage.Methods:The official websites of the People's Government of Anhui Province and the Anhui Provincial Drug Administration were searched by using the keywords of"medical devices","medical device enterprises",and"medical consumables"to search for medical device related policy documents released from January 2011 to December 2022.The 21 medical device-related policy documents retrieved shall be coded using the content analysis method in the sequence of"policy code-chapter number-unit number-sentence number".A two-dimensional analytical framework of"Basic Policy Instruments-Involved Subjects"was constructed to quantitatively analyze the medical device policy text from the two dimensions of policy instruments-involved subjects.Results:A total of 338 items were codes,including 107 supply-based policy tools(accounting for 31.66%),40 demand-based policy tools(accounting for 11.83%),and 191 environmental policy tools(accounting for 56.51%).The 338 codes involved entities including 202 government departments(accounting for 59.76%),62 operating enterprises(accounting for 18.34%),59 production enterprises(accounting for 17.46%),9 medical institutions(accounting for 2.66%),and 6 industry associations(accounting for 1.78%).Conclusion:The medical device policy in Anhui Province is mainly based on environmental policy tools,and demand-based policy tools are rarely used.The rationality of the distribution of internal items and participating entities in policy tools needs to be improved.There are certain differences in the interaction between each entity and policy tools.Therefore,it is necessary to strengthen the balance of policy tool use,increase the participation of multiple entities,and optimize the synergy between entities and policy tools.
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Objective It analyzes the characteristics of the policy text of Sanming City on the basis of two dimen-sions,policy tools and policy objectives,to accumulate the experience of abolishing the increase in the price of tradi-tional Chinese medicine tablets in Sanming City,and puts forward some reflections.Methods Using literature re-search combined with content analysis,a two-dimensional analysis framework of policy tools and objectives was constructed to code 26 policy documents published publicly in Sanming City from January 2013-April 2023 regarding the policy of abolishing the markup on Chinese medicine tablets.Results A total of 87 articles were coded,with de-mand-type,supply-type and environment-type accounting for 16.09 per cent,34.49 per cent and 49.42 per cent respectively,with the overall distribution of policy tools favouring the use of supply-type and environment-type;and there was a certain tendency towards a certain policy objective,"ensuring the quality of Chinese medicine tablet","improving the price mechanism of Chinese medicine tablets","standardising the use of Chinese medicine tablets","strengthening the organisation and implementation,and implement the government's responsibility to invest"ac-counted for 11.49%per cent,39.08 per cent,18.39 per cent and 31.03 per cent respectively.Conclusion Innovative use of demand-based tools,such as market shaping,to promote the development of the beverage production chain in a high quality manner;taking into account the level of the regional economy,returning the price initiative to the market,optimising the market structure of the traditional Chinese medicine beverage industry,and cooperating with publicity measures to promote the implementation of the policy;and reforming the personnel and remuneration system of the pharmacy staff and regulating medical practices.
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OBJECTIVE To analyze the traditional Chinese medicine （TCM） emergency management policy texts in China， reveal the characteristics， problems and improvement directions of Chinese medicine emergency management policies in China， and provide references and lessons for improving the level of Chinese medicine emergency management. METHODS Twenty-four TCM emergency management policy texts issued at the central level from 2016 to 2023 were coded and analyzed using Nvivo11 software to construct a three-dimensional analysis framework based on policy tools， stakeholders and policy strength. RESULTS In the policy tools dimension， the environmental type was the most （46.74%）， the supply type was the second （31.80%）， and the demand type was the least （21.46%）； in the stakeholder dimension， there were more healthcare institutions （40.63%） and government departments （31.25%）， and fewer healthcare workers （14.84%） and residents （13.28%）； in the policy strength dimension， the overall policy strength was poor， and the differences in effectiveness across policy instruments and stakeholders were more significant. The cross-cutting results showed that there was a certain degree of mismatch in policy instruments， stakeholders and policy strength. CONCLUSIONS The use of supply-oriented policy tools is slightly lacking， and the use of policy tools should be optimized in a coordinated manner； the distribution of stakeholders is relatively unbalanced， and synergies among stakeholders should be enhanced； the overall strength of policies is poor， and the top-level design of relevant policies should be improved.
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Objective:To quantitatively analyze the policy of maternal and child health talents in Yangtze River Delta,and to provide reference for optimizing the policy.Methods:The three-dimensional framework of policy tools,policy objectives and policy objects was constructed,and the policy texts retrieved from the official websites of people's governments of three provinces and one city,health Commission,Human resources and Social Security Department were analyzed by quantitative policy analysis method.Results:A total of 239 documents were included.The main policy tools were supply tools(47.7%)and demand tools(32.1%).The main policy goal is to cultivate talents(53.2%);The main policy objects were universal(61.1%)and high-level talents(18.9%).Conclusion:The importance of maternal and child health talent policy in the Yangtze River Delta is increasing day by day,and the regional coordination is improving,but the coordination of the combination and collocation of policies still needs to be optimized,and there is strong convergence among different regions.It is necessary to promote the construction of talent highland and information platform,improve the operability of policies and carry out incentive and evaluation trials,increase the talent training and evaluation policies and introduction and publicity policies,train and make good use of middle-level talents,and create their own characteristics under the framework of regional cooperation.
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Objective:To make a quantitative analysis of the policy tools which is related to the public hospital compensation policy text to reveal the characteristics of different stages in the policy and the use of the policy tools.Methods:Content analysis was performed to construct a two-dimensional framework of"tools(X-dimension)-phases(Y-dimension)",and analyze the use of public hospital compensation policy tools.Results:From the Y-dimension,the use of public hospital compensation policy tools in different stages shows the characteristics of differentiation and diversification.However,according to the X-dimension,there is uneven development rate and poor combination structure of public hospital compensation policy tools.And partial policy sub-tools are seriously missing,and failed to complement each other.On this basis,policy suggestions are put forward:optimize the combination of various policy tools,innovate the means of demand-based policy tools,and make up for the shortcomings of supply-based policy tools.Optimize the combination of various policy tools,innovate the means of demand-based policy tools,and make up for the shortcomings of supply-based policy tools.
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Objective:To provide reference for improving the provincial Internet plus medical service medical insurance payment policy in China.Methods:From three dimensions of policy tools,participants and policy placement,the distribution characteristics of the Internet plus medical service and medical insurance payment related policies that have been issued in 31 provinces of China were analyzed.A total of 58 policy documents were collected,forming 1585 text items.Results:A total of 597 text items were selected for policy tools(X dimension),with supply based,demand based,and environmental based policy items accounting for 20.6%,16.6%,and 62.8%,respectively.A total of 574 text items were selected for the participating entities(Y-dimension),and 414 text items were selected for the policy placement(Z-dimension).Conclusion:There is a structural imbalance in policy tools,and complementarity and coordination should be enhanced.There are significant differences in the application of policy tools among participating entities,and the division of labor and collaboration among participating entities should be deepened.The practicality of policy implementation is not strong,and close connections between links should be strengthened.The distribution of policies among regions is not balanced enough,and policy design should be optimized according to local conditions.
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Objective:To analyse China′s Traditional Chinese Medicine(TCM) health service policy from the perspective of policy life cycle, so as to provide reference for improving the policy system of TCM health service.Methods:The official websites of national government agencies were searched for policy documents on TCM health service from 2012 to 2022, using the keywords of " Chinese medicine" " Traditional Chinese Medicine" and " health service", and policy text entries were extracted and coded. A two-dimensional analytical framework of policy tools(supply, demand, and environment) and policy life cycle(agenda setting, policy formulation, policy implementation, and policy evaluation) was constructed to quantitatively analyze the policy texts.Results:A total of 58 policy documents were included, containing 2 898 text entries. The distribution of policy instruments was uneven, with a high percentage of entries using supply-based instruments(40.57%, 1 176 entries), followed by environmental instruments(38.86%, 1 126 entries) and demand-based instruments(20.57%, 596 entries). From the perspective of policy cycle, the policy tools were mainly concentrated in the stages of policy formulation(53.77%, 1 558 entries) and policy implementation(36.86%, 1 068 entries), while the policy tools in the stages of agenda setting(4.97%, 144 entries) and policy evaluation(4.40%, 128 entries) needed to be strengthened.Conclusions:In recent years, the distribution of policy tools in China′s TCM health service policy was uneven, and the articulation of the stages in the policy life cycle needed to be strengthened.
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Objective:To analysis the policy tools and targets of the policies of free training for order-oriented medical students in rural areas of China, for reference for further improving the free medical student training policy.Methods:The research team searched the official websites of the State Council, National Health Commission, Ministry of Education, and other ministries, as well as the Peking University Treasure Database, for national level policy documents related to free training of order-oriented medical students released from June 2010 to May 2023. Policy tool-policy target analysis framework was used to quantitative analysis the policy documents.Results:A total of 16 policy documents were included and 213 policy provisions were extracted. From the perspective of policy tools, the proportion of policy provisions using imperative policy tools was the highest, accounting for 63.38% (135 articles), followed by advisory policy tools(18.78%, 40 articles)and reward based policy tools(13.61%, 29 articles), while functional expansion tools(2.82%, 6 articles) and authoritative restructuring tools(1.41%, 3 articles) accounted for a relatively low proportion. The institutional education stage is the main policy target, with provisions accounting for 76.06% (162 articles), followed by the continuing education stage and the post graduation education stage, accounting for 17.84% (38 articles) and 7.51% (16 articles), respectively. It was uneven distribution of various policy tools and their sub tools within the same policy target.Conclusions:The distribution of policy tools for the free training policy of rural order oriented medical students in China needed to be further balanced. The policy targets were mainly concentrated in the education stage of universities.
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Objective:To analyze the policy tools designed for function orientation and development of China′s infectious disease hospitals, in order to provide references for formulating and optimizing the functional implementation and sustainable development policies of these hospitals.Methods:Consulting the website of Peking University Law and official websites on health, and using such keywords as " medical institutions, infectious diseases, hospitals for infectious diseases, public health emergencies, specialized hospitals", and searching the national policy texts on the functions and development of infectious disease hospitals issued from December 1991 to January 2023. By means of Rothwell and Zegveld′s policy tool classification method, Nvivo 11 Pro software was used to analyze the text content from the dimensions of demand-type, supply-type, and environmental-type policy tools.Results:A total of 41 policy texts were included and 204 codes were obtained through text analysis. Of all the tools, environmental and supply-oriented policy tools were used the most, being 104 (50.99%) and 95 (46.56%) respectively, while demand-oriented policy tools were used the least, only 5 (2.45%). Of all the environmental-oriented policy tools, " goal planning" was the most used, being 34 (16.67%), while " publicity and guidance" was less used, only 4 (1.96%). Among the supply-oriented policy tools, " clarifying the reporting and handling service functions of public health emergencies" was the most widely used, being 34 (16.67%), while " Informationization" and " infrastructure construction" was less used, being 8 (3.92%) and 6 (2.94%) respectively. Few of the demand-oriented policy tools were in use, as " government purchase" and " medical insurance support" were both 2 (0.98% each), and " social medical care" was only 1 (0.49%).Conclusions:The distribution of three types of policy tools for function and development of infectious disease hospitals is unbalanced, the use of environmental and supply-oriented policy tools is excessive and internal structure is unbalanced. The proportion of environmental-oriented policy tools needs to be adjusted, and the frequency of use of supporting tools such as relevant standards, norms, incentives, supervision and publicity should be increased. Supply-oriented policies need to be further optimized, especially in terms of personnel training, funding, information technology and infrastructure construction. Demand-oriented policy tools are seriously underused and need to be further developed.
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Objective:To understand the status of medical science and technology achievement transformation policies in application, this study conducted a descriptive statistical analysis of the collected relevant policy texts according to type, time, and publication sector. On this basis, the X-Y two-dimensional analysis framework of policy texts is constructed using the dual dimensions of Howlett and Ramesh′s policy tool classification and policy development to classify policies into 3 categories: mandatory tools, voluntary tools, and hybrid tools, and to quantify the policy texts on the transformation of medical science and technology achievements, analyze the policy support received in the transformation of medical science and technology achievements and the policy obstacles in the transformation of achievements in China. Finally, this study was aiming to propose targeted countermeasure suggestions.Methods:The texts of medical achievement transformation policies were collected through the official websites of the State Council and the Ministry of Science and Technology, and combined with relevant literature. Research methods such as literature research method and quantitative and qualitative analysis method were applied to conduct the study. The policy samples were coded and organized, and two-dimensional analysis was conducted through the constructed X-Y two-dimensional analysis framework. The texts were quantitatively analyzed through a combination of quantitative and qualitative methods.Results:The results of the analysis of the coded data revealed that the current mandatory tools of China′s medical science and technology achievement transformation policy account for a relatively high proportion, and the use of voluntary tools still needed to be further improved. The use of various policy tools was uneven. The internal structure of various policy tools was also uneven, and there was still room for improvement.Conclusions:Through qualitative and quantitative analysis of the results of the application of medical science and technology achievement transformation policy in China, this paper puts forward 3 countermeasure suggestions: firstly, in the stage of policy strengthening and implementation, the implementation path and scheme of policy tools need to be refined so that the policy can realize implementation. Secondly, the balanced development of various policy tools, the coordination of policy formulation and implementation, the balanced role of mandatory tools, hybrid tools and voluntary tools, and the establishment of a smooth policy system for the transformation of medical science and technology results on this basis to improve the effectiveness of the policy. Thirdly, improve the internal orientation and evaluation mechanism of medical institutions to motivate medical institutions and medical personnel to carry out scientific and technological innovation and transformation work.
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Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.
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OBJECTIVE：To study the current situation of traditional Chinese medicine （TCM）industry policy in Guangdong- Hong Kong-Macao greater bay area ，and to provide suggestions for the follow-up planning and layout. METHODS ：The content analysis method was used to code and measure the policy text of TCM industry in Guangdong-Hong Kong-Macao greater bay area issued by the central government and local government as of April 2020 from the perspective of policy tools. The current development focus and existing problems of the industry were summarized to put forward reasonable suggestion. RESULTS & CONCLUSIONS：A total of 34 relevant policy texts were retrieved ，including 9 at the central government level and 25 at the local government level. In respective of essential policy tool ，the supply-oriented ，demand-oriented and environmental policy tools of TCM industry in Guangdong-Hong Kong-Macao greater bay area accounted for 58.10％，22.86％ and 19.05％，respectively. Among supply-oriented policy tools ，hardware construction accounted for 40.98％，internal communication for 26.23％，quality construction for 22.95％，and international exchange for 9.84％；there was no specific implementation rules and programs for policy tools ，which affect their operability. The demand-oriented policy tools included health service （75.00％），international trade （16.67％），service outsourcing （4.17％）and government subsidies （4.17％）；the use of the latter three approaches limited the openness of the industrial market. The environmental policy tools included target planning （40.00％），access rules （25.00％）， intellectual property （30.00％）and financing support （5.00％），but needed to improve the support of laws and regulations and relevant measures. In respective of the value chain of TCM industry ，34 policy texts showed 4 contents，including platform construction（36.19％），scientific and technological innovation （19.05％），market expansion （23.81％），exchange and cooperation （20.95％）；the lack of scientific and technological innovation and exchange and cooperation limited the standardization ， modernization and internationalization of TCM. It suggested to optimize the supply-oriented policy tools ，improve the operability of policies； pay attention to the demand-oriented and environmental policy tools ， highlight the role of marketization and standardization；pay attention to the integration of basic policy tools and industrial value chain ，and achieve the standardization ， modernization and international development of TCM in Guangdong-Hong Kong-Macao greater bay area.
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Objective:To compare and analyze the choice and application of policy tools in the construction of hierarchical medical system in different provinces of china, and to provide advice for improving the effectiveness of the hierarchical medical policy implementation. Methods:Retrieve the policy documents of provincial governments on hierarchical medical policy through internet search;sort names and categories of policy tools based on the classifica-tion of policy tools by Rothwell&Zegveld after consulting the expert,and analyze the use of policy tools by calculating the frequency of different policy tools. Results:This study has summed up 15 types of policy tools in 3 categories in-cluding demand,supply,and environment of provincial hierarchical medical policy. Supply policy tools accounted for 32.92%,demand policy tools accounted for 20.58%, and environmental policy tools accounted for 46.50%. The most widely used policy tool is the regulatory control, and the least used policy tool is the disease catalog. Conclu-sions:Among the choice of policy tools,the category of environmental policy tools are the most widely used,and de-mand policy tools are applied the least. The use of three types of policy tools in the eastern region are balanced,the demand policy tools in Central China are relatively few, and the environmental policy tools are widely used in the western region,while the demand oriented policy tools are scarce.