Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path
Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bo...
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| Autor*in: |
WU Yuxia, MA Hongbo, MI Hong [verfasserIn] |
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E-Artikel |
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| Sprache: |
Chinesisch |
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2024 |
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In: Zhongguo quanke yixue - Chinese General Practice Publishing House Co., Ltd, 2024, 27(2024), 13, Seite 1638-1644 |
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volume:27 ; year:2024 ; number:13 ; pages:1638-1644 |
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| DOI / URN: |
10.12114/j.issn.1007-9572.2023.0404 |
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DOAJ091482720 |
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| 520 | |a Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. | ||
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10.12114/j.issn.1007-9572.2023.0404 doi (DE-627)DOAJ091482720 (DE-599)DOAJ0da183f21be441e88ea886debbe141a0 DE-627 ger DE-627 rakwb chi WU Yuxia, MA Hongbo, MI Hong verfasserin aut Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work Medicine R In Zhongguo quanke yixue Chinese General Practice Publishing House Co., Ltd, 2024 27(2024), 13, Seite 1638-1644 (DE-627)DOAJ090664779 10079572 nnns volume:27 year:2024 number:13 pages:1638-1644 https://doi.org/10.12114/j.issn.1007-9572.2023.0404 kostenfrei https://doaj.org/article/0da183f21be441e88ea886debbe141a0 kostenfrei https://www.chinagp.net/fileup/1007-9572/PDF/20230404.pdf kostenfrei https://doaj.org/toc/1007-9572 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 27 2024 13 1638-1644 |
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10.12114/j.issn.1007-9572.2023.0404 doi (DE-627)DOAJ091482720 (DE-599)DOAJ0da183f21be441e88ea886debbe141a0 DE-627 ger DE-627 rakwb chi WU Yuxia, MA Hongbo, MI Hong verfasserin aut Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work Medicine R In Zhongguo quanke yixue Chinese General Practice Publishing House Co., Ltd, 2024 27(2024), 13, Seite 1638-1644 (DE-627)DOAJ090664779 10079572 nnns volume:27 year:2024 number:13 pages:1638-1644 https://doi.org/10.12114/j.issn.1007-9572.2023.0404 kostenfrei https://doaj.org/article/0da183f21be441e88ea886debbe141a0 kostenfrei https://www.chinagp.net/fileup/1007-9572/PDF/20230404.pdf kostenfrei https://doaj.org/toc/1007-9572 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 27 2024 13 1638-1644 |
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10.12114/j.issn.1007-9572.2023.0404 doi (DE-627)DOAJ091482720 (DE-599)DOAJ0da183f21be441e88ea886debbe141a0 DE-627 ger DE-627 rakwb chi WU Yuxia, MA Hongbo, MI Hong verfasserin aut Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work Medicine R In Zhongguo quanke yixue Chinese General Practice Publishing House Co., Ltd, 2024 27(2024), 13, Seite 1638-1644 (DE-627)DOAJ090664779 10079572 nnns volume:27 year:2024 number:13 pages:1638-1644 https://doi.org/10.12114/j.issn.1007-9572.2023.0404 kostenfrei https://doaj.org/article/0da183f21be441e88ea886debbe141a0 kostenfrei https://www.chinagp.net/fileup/1007-9572/PDF/20230404.pdf kostenfrei https://doaj.org/toc/1007-9572 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 27 2024 13 1638-1644 |
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10.12114/j.issn.1007-9572.2023.0404 doi (DE-627)DOAJ091482720 (DE-599)DOAJ0da183f21be441e88ea886debbe141a0 DE-627 ger DE-627 rakwb chi WU Yuxia, MA Hongbo, MI Hong verfasserin aut Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work Medicine R In Zhongguo quanke yixue Chinese General Practice Publishing House Co., Ltd, 2024 27(2024), 13, Seite 1638-1644 (DE-627)DOAJ090664779 10079572 nnns volume:27 year:2024 number:13 pages:1638-1644 https://doi.org/10.12114/j.issn.1007-9572.2023.0404 kostenfrei https://doaj.org/article/0da183f21be441e88ea886debbe141a0 kostenfrei https://www.chinagp.net/fileup/1007-9572/PDF/20230404.pdf kostenfrei https://doaj.org/toc/1007-9572 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 27 2024 13 1638-1644 |
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10.12114/j.issn.1007-9572.2023.0404 doi (DE-627)DOAJ091482720 (DE-599)DOAJ0da183f21be441e88ea886debbe141a0 DE-627 ger DE-627 rakwb chi WU Yuxia, MA Hongbo, MI Hong verfasserin aut Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work Medicine R In Zhongguo quanke yixue Chinese General Practice Publishing House Co., Ltd, 2024 27(2024), 13, Seite 1638-1644 (DE-627)DOAJ090664779 10079572 nnns volume:27 year:2024 number:13 pages:1638-1644 https://doi.org/10.12114/j.issn.1007-9572.2023.0404 kostenfrei https://doaj.org/article/0da183f21be441e88ea886debbe141a0 kostenfrei https://www.chinagp.net/fileup/1007-9572/PDF/20230404.pdf kostenfrei https://doaj.org/toc/1007-9572 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ AR 27 2024 13 1638-1644 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">DOAJ091482720</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240412093718.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240412s2024 xx |||||o 00| ||chi c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.12114/j.issn.1007-9572.2023.0404</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ091482720</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ0da183f21be441e88ea886debbe141a0</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">chi</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">WU Yuxia, MA Hongbo, MI Hong</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2024</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. 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WU Yuxia, MA Hongbo, MI Hong |
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WU Yuxia, MA Hongbo, MI Hong misc health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work misc Medicine misc R Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path |
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Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path health governance|hierarchical diagnosis|medical and social cooperation|community smart health huts|health social work |
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medical and social cooperation and community smart health huts: reconstruction of hierarchical diagnosis and treatment path |
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Medical and Social Cooperation and Community Smart Health Huts: Reconstruction of Hierarchical Diagnosis and Treatment Path |
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Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. |
| abstractGer |
Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. |
| abstract_unstemmed |
Background One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders. Objective To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow. Methods From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation. Results The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment. |
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These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved. Conclusion The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. 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