广西医学

目的探讨政策工具视角下当前我国临床专科能力建设政策体系的结构与特征，为我国临床专科能力建设相关政策的编制与优化提供参考。方法对我国2010—2024年颁布的与临床专科能力建设密切相关的政策文件进行梳理，基于政策工具理论，构建基本政策工具类型（X维度）与政策发展阶段（Y维度）的二维分析框架，运用内容分析法对我国临床专科能力建设相关政策文件进行分析。结果 X维度中，供给型、环境型、需求型政策工具的使用比例分别为29.5%、61.0%、9.5%；Y维度中，项目试点阶段、项目推进阶段、全面建设阶段政策工具的使用比例分别为41.6%、22.6%、35.8%。结论当前我国临床专科能力建设政策工具使用上存在需求型政策工具使用不足、环境型政策工具应用较多的问题，政策发展各个阶段的政策工具使用在侧重点上各有不同，但部分政策工具使用数量分布不均。建议在相关政策设计上应加强需求型政策工具的使用，适当减少环境型政策工具的使用，并进一步优化政策工具内部结构，强化临床专科能力建设政策顶层设计，统筹各类政策工具在政策发展过程中的运用，确保政策稳步推进。

Objective To explore the structure and characteristics of the current policy system for clinical specialty capacity construction in China from the perspective of policy tools, and to provide references for the formulation and optimization of relevant policies for clinical specialty capacity construction in China. Methods Policy documents closely related to clinical specialty capacity construction promulgated in China from 2010 to 2024 were reviewed. Basic policy tool type (dimension X) and two⁃dimensional analysis framework during policy development (dimension Y) were constructed based on the policy tools theory. The content analysis method was employed to analyze policy documents related to clinical specialty capacity construction in China. Results In dimension X, the proportions of supply⁃oriented type, environmental⁃oriented type, and demand⁃oriented type of policy tools used were 29.5%, 61.0%, and 9.5%, respectively. In dimension Y, the proportions of policy tools used in project pilot stage, project promotion stage, and comprehensive construction stage were 41.6%, 22.6%, and 35.8%, respectively. Conclusion At present, there are insufficient use of demand⁃oriented policy tools and more application problems of environmental⁃oriented policy tools in the use of policy tools for clinical specialty capacity construction in China; furthermore, the use of policy tools in different stages of policy development varies in focus, but the number of policy tools used was unevenly distributed. It is suggested that in the design of relevant policies, the use of demand⁃oriented policy tools should be strengthened, the use of environmental⁃oriented policy tools should be appropriately reduced, the internal structure of policy tools should be further optimized, the top⁃level design of clinical specialty capacity construction policy should be strengthened, and the application of various policy tools in the process of policy development should be coordinated to ensure the steady progress of the policy.

ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref
ref