山东大学学报 (医学版) ›› 2026, Vol. 64 ›› Issue (7): 90-99.doi: 10.6040/j.issn.1671-7554.0.2025.1344
宋文锦1,黄佳微1,洪子轩1,郭颖1,白忠良1,2
SONG Wenjin1, HUANG Jiawei1, HONG Zixuan1, GUO Ying1, BAI Zhongliang1,2
摘要: 目的 系统剖析我国主动健康政策文本的结构特征与协同逻辑,揭示现存问题与优化方向,为完善主动健康政策体系、提升治理效能提供参考。 方法 运用Nvivo 15软件对2016—2024年国家层面发布的50份主动健康政策文本进行编码,构建基于政策工具、利益相关者和政策目标的三维分析框架,采用内容分析法进行单维度描述统计与多维度交叉分析。 结果 政策工具维度中,供给型(46.76%)与环境型(35.49%)工具占主导,需求型工具相对匮乏(17.75%);利益相关者维度中,政府(49.08%)占据绝对主导地位,非政府组织参与严重不足(1.74%),公众(21.21%)、医疗机构(17.52%)、企业(5.53%)、科研机构与高校(4.92%)参与度依次递减;政策目标以优化健康服务(57.14%)和提升公众健康水平(29.03%)为主,加快健康科技创新(7.68%)、发展健康产业(3.53%)和降低医疗负担(2.61%)目标的支持相对薄弱。交叉分析显示,政策工具、利益相关者与政策目标之间存在结构性错配。 结论 我国主动健康政策呈现供给主导、政府中心、服务优先的结构性特征。建议优化政策工具组合,强化需求型工具与刚性约束;构建多元主体协同机制,激发市场与社会活力;均衡政策目标布局,重点补足医疗负担等领域短板,以推动主动健康政策体系向更加均衡、高效、可持续的方向发展。
中图分类号:
| [1] | 李祥臣, 俞梦孙. 主动健康: 从理念到模式[J]. 体育科学, 2020, 40(2): 83-89. Li Xiangchen, Yu Mengsun. Proactive health: from idea to model[J]. China Sport Science, 2020, 40(2): 83-89. |
| [2] | 何柳华, 金花, 郭爱珍, 等. 主动健康导向下社区赋能对基层慢性病管理的作用及实施策略[J]. 中国全科医学, 2025, 28(34): 4311-4317. He Liuhua, Jin Hua, Guo Aizhen, et al. The role and implementation strategy of community empowerment in chronic disease management under active health orientation[J]. Chinese General Practice, 2025, 28(34): 4311-4317. |
| [3] | 黎婉钰, 付强强, 金花, 等. 主动健康视角下慢性病患者健康素养水平及影响因素研究[J]. 中国全科医学, 2025, 28(11): 1315-1319. Li Wanyu, Fu Qiangqiang, Jin Hua, et al. Analysis of health literacy levels and influencing factors of chronic disease patients under active health perspective[J]. Chinese General Practice, 2025, 28(11): 1315-1319. |
| [4] | 车峰, 马峥嵘. 健康中国背景下医养结合服务政策内容分析与优化建议: 基于政策工具与参与主体的二维视角[J]. 学习论坛, 2024(1): 78-84. Che Feng, Ma Zhengrong. Content analysis and optimization suggestions for the policy of combined medical and nursing services in the context of healthy China: based on the two-dimensional perspective of policy instruments and participating subjects[J]. Tribune of Study, 2024(1): 78-84. |
| [5] | 张倩倩, 金花, 史晓晓, 等. 我国主动健康的实施现状及对各责任主体实施策略的建议[J]. 中国全科医学, 2022, 25(31): 3923-3927, 3932. Zhang Qianqian, Jin Hua, Shi Xiaoxiao, et al. Proactive care in China: implementation status and recommendation strategies for various undertaking bodies[J]. Chinese General Practice, 2022, 25(31): 3923-3927, 3932. |
| [6] | 朱天顺, 朱可可, 焦聪聪, 等. 健康中国背景下主动健康在老龄化社会中的应用分析[J]. 卫生软科学, 2025, 39(1): 23-26. Zhu Tianshun, Zhu Keke, Jiao Congcong, et al. Analysis of the application of proactive health in the ageing society in the context of Healthy China[J]. Soft Science of Health, 2025, 39(1): 23-26. |
| [7] | 陈超亿, 陈浩, 冯占春, 等. 数字健康视角下主动健康管理内涵及优化路径[J]. 中国预防医学杂志, 2024, 25(11): 1463-1468. Chen Chaoyi, Chen Hao, Feng Zhanchun, et al. Exploring the connotation and optimization pathways of proactive health management from the perspective of digital health[J]. Chinese Preventive Medicine, 2024, 25(11): 1463-1468. |
| [8] | 周辰茜, 林蓓蕾, 唐尚锋, 等. 脑卒中患者主动健康行为概念框架的构建研究[J]. 中国全科医学, 2025, 28(5): 534-540, 547. Zhou Chenxi, Lin Beilei, Tang Shangfeng, et al. Construction of conceptual framework of proactive health behavior in stroke patients[J]. Chinese General Practice, 2025, 28(5): 534-540, 547. |
| [9] | 曹蒙, 田庆丰, 陆雅琦, 等. 主动健康视域下中医文化在农村健康养老领域的应用研究[J]. 中国农村卫生事业管理, 2024, 44(10): 748-753. Cao Meng, Tian Qingfeng, Lu Yaqi, et al. Application of traditional Chinese medicine culture in rural health and elderly care from the perspective of active health[J]. Chinese Rural Health Service Administration, 2024, 44(10): 748-753. |
| [10] | 李芯瑶, 李敏, 巢健茜, 等. 基于政策工具与利益相关者二维框架的我国公立医院薪酬政策文本量化分析[J]. 山东大学学报(医学版), 2025, 63(9): 47-56. Li Xinyao, Li Min, Chao Jianqian, et al. Quantitative analysis of Chinas public hospital salary policy texts based on the two-dimensional framework of policy tools and stakeholders[J]. Journal of Shandong University(Health Science), 2025, 63(9): 47-56. |
| [11] | 岳喜优. 基于内容分析法的我国健康产业发展政策研究[J]. 南京中医药大学学报(社会科学版), 2021, 22(2): 151-156. Yue Xiyou. Research on Chinas health industry development policy based on content analysis method[J]. Journal of Nanjing University of Traditional Chinese Medicine(Social Science Edition), 2021, 22(2): 151-156. |
| [12] | Rothwell R, Zegveld W. Reindustrialization and techno-logy[M]. Harlow: Longman, 1985,83-104. |
| [13] | Freeman R E. Strategic management: astakholder approach [J]. Journal of Management Studies, 1984, 29(2): 131-154. |
| [14] | Petek A, Zguri c B, Šinko M, et al. From hierarchy to continuum: classifying the technical dimension of policy goals[J]. Policy Sci, 2022, 55(4): 715-736. |
| [15] | 李浩, 戴遥, 陶红兵. 我国DRG政策的文本量化分析: 基于政策目标、 政策工具和政策力度的三维框架[J]. 中国卫生政策研究, 2021, 14(12): 16-25. Li Hao, Dai Yao, Tao Hongbing. Text quantitative analysis of Chinas DRG policy: a three-dimensional framework based on policy objectives, policy tools and policy strength[J]. Chinese Journal of Health Policy, 2021, 14(12): 16-25. |
| [16] | 高丽敏, 姜连平. 关于我国卫生改革政策目标的思考[J]. 中国卫生经济, 2001, 20(3): 27-29. Gao Limin, Jiang Lianping. Thinking about the aim of health reform in China[J]. Chinese Health Economics, 2001, 20(3): 27-29. |
| [17] | 李方晖, 何茄菡, 崔博文, 等. “理想之治”与“现实之困”: 政策工具视角下我国体卫融合政策的文本特征与优化路径[J]. 南京师大学报(自然科学版), 2024, 47(4): 148-156. Li Fanghui, He Jiahan, Cui Bowen, et al. The “ideal rule” and the “difficulties of reality”: textual charac-teristics and optimization path of Chinas physical and health integration policies from the perspective of policy instruments[J]. Journal of Nanjing Normal University(Natural Science Edition), 2024, 47(4): 148-156. |
| [18] | 李本乾. 描述传播内容特征检验传播研究假设: 内容分析法简介(下)[J]. 当代传播, 2000(1): 47-49, 51. Li Benqian. Describe the characteristics of communication content and test the hypothesis of communication research: introduction of content analysis method(II)[J]. Contemporary Communications, 2000(1): 47-49, 51. |
| [19] | 韩征强, 邹青海, 孙玉玉, 等. 主动健康视域下运动促进健康新模式发展的要素结构、 现实瓶颈与纾解策略[J]. 沈阳体育学院学报, 2024, 43(4): 73-80. Han Zhengqiang, Zou Qinghai, Sun Yuyu, et al. Elemental structure, practical bottlenecks and relief strategies of development of new model on exercises for health promotion from the perspective of active health[J]. Journal of Shenyang Sport University, 2024, 43(4): 73-80. |
| [20] | 徐有粮, 张孜贤, 吴绍奎, 等. 积极老龄化背景下主动健康与体育促进: 内涵、定位与个性方案[J]. 山东体育学院学报, 2024, 40(2): 18-27. Xu Youliang, Zhang Zixian, Wu Shaokui, et al. Active health and sports promotion in the context of active aging: connotation, orientation, and personalized programs[J]. Journal of Shandong Sport University, 2024, 40(2): 18-27. |
| [21] | 梁超, 宋振鹏, 汤立许. 数智赋能主动健康管理: 实践样态、 建构策略与驱动路径[J]. 武汉体育学院学报, 2024, 58(4): 72-81. Liang Chao, Song Zhenpeng, Tang Lixu. Digital intelligence enabled proactive health management: practice pattern, construction strategy and driving path[J]. Journal of Wuhan Sports University, 2024, 58(4): 72-81. |
| [22] | 陈晓敏, 杨佳敏, 陈丹镝, 等. 基于政策工具的我国1999—2023年心理健康和精神卫生政策文本量化分析[J]. 现代预防医学, 2024, 51(5): 877-882. Chen Xiaomin, Yang Jiamin, Chen Dandi, et al. Quantitative analysis of Chinas mental health and mental hygiene policy text in 1999—2023 based on policy tools[J]. Modern Preventive Medicine, 2024, 51(5): 877-882. |
| [23] | 韩娟娟, 张新安, 孟欣. 数智赋能老年主动健康的多维困境与破解策略[J]. 广州体育学院学报, 2025, 45(4): 34-40, 50. Han Juanjuan, Zhang Xinan, Meng Xin. The fundamental connotation, practical challenges, and resolving pathways of digital intelligence-empowered active health for the elderly[J]. Journal of Guangzhou Sport University, 2025, 45(4): 34-40, 50. |
| [24] | 廖粤生, 刘洪武, 王先亮. 我国实施主动健康战略的理论价值、 现实困境与纾解方略[J]. 中国卫生经济, 2023, 42(9): 1-5. Liao Yuesheng, Liu Hongwu, Wang Xianliang. The theoretical value, realistic dilemma, and relief strategy of implementing active health strategy in China[J]. Chinese Health Economics, 2023, 42(9): 1-5. |
| [25] | 刘晓瑞, 付唯, 卫雅伦, 等. 生命早期卫生健康政策内容研究: 基于北京市政策文本分析[J]. 中国卫生政策研究, 2023, 16(11): 39-46. Liu Xiaorui, Fu Wei, Wei Yalun, et al. Research on the health policy of early life: based on analysis of policy texts of Beijing city[J]. Chinese Journal of Health Policy, 2023, 16(11): 39-46. |
| [26] | 张健, 姜京徽, 陈靖林, 等. 我国主动健康发展现状、挑战及对策研究[J]. 中国工程科学, 2025, 27(6): 81-91. Zhang Jian, Jiang Jinghui, Chen Jinglin, et al. Proactive health in China: current status, challenges, and policy responses[J]. Strategic Study of Chinese Academy of Engineering, 2025, 27(6): 81-91. |
| [27] | 黄佳微, 王正盛, 宋文锦, 等. 政策工具视角下我国老年友善医疗机构政策文本量化分析[J]. 中国医院, 2025, 29(12): 41-45. Huang Jiawei, Wang Zhengsheng, Song Wenjin, et al. Quantitative analysis of policy texts on age-friendly medical institutions in China from the perspective of policy tools[J]. Chinese Hospitals, 2025, 29(12): 41-45. |
| [1] | 李芯瑶,李敏,巢健茜,金圣玹,陈兼立,郝泽铭. 基于政策工具与利益相关者二维框架的我国公立医院薪酬政策文本量化分析[J]. 山东大学学报 (医学版), 2025, 63(9): 47-56. |
| [2] | 韩霜,田晓伟,张新宇,孔杨. 政策工具视角下山东省“体医养融合”政策优化研究[J]. 山东大学学报 (医学版), 2025, 63(7): 116-124. |
| [3] | 娄鹏宇,代海岩,伊利. 山东省农村居民基本药物制度知识-态度-行为分析[J]. 山东大学学报(医学版), 2012, 50(12): 122-125. |
|
||