基于系统动力学的基层医疗机构服务能力优化模型研究

The key to solve medical problem is to strengthen the capability of grass-roots medical institutions. This view has been accepted by the society from all walks of life. The effect of which is still weak, although the construction of basic medical system has been taken as a top priority in the new medical reform. . The capability optimization of grassroots medical institutions is complicated social economic opening system; its internal operating mechanism is not entirely clear till now. The traditional methods, like econometric, can not resolve this nonlinear system. It is necessary to build a systematic policy system in the perspective of system theory by applying system dynamics model which is suitable for complex social systems. However, most of the present research is focus on the constructing evaluation index system and the assessment by which, few adopt the dynamic systemic view which analyze the internal and external factors comprehensively. . The study is to provide basis and reference for government policy making in national grassroots medical institution reform by exploring the capability optimization mechanism of grassroots medical institutions and by seeking the key control factors and policy targets of capability optimization by predicting the effect of simulated policy. The former needs to focus on the main body and to clear their correlations by using system dynamics model in the perspective of system theory.

破解“看病”难题的关键是加强基层医疗机构服务能力，该观点已被社会各界认可，虽然国家将基层医疗卫生体系建设作为新医改政策体系的重中之重，但改革成效甚微。. 基层医疗机构服务能力优化是复杂社会经济开放系统，其内部运行机制目前尚不完全清晰，传统的计量经济学等研究方法无法处理这种非线性系统，需要以系统论为视角，借助适用于研究复杂社会系统的系统动力学模型，构建系统性政策体系予以解决，但目前相关研究主要集中于构建评价指标体系，开展能力评价，较少有将内外要素进行综合分析的动态系统性研究。. 本研究以系统论为视角，运用系统动力学模型，通过聚焦基层医疗机构服务能力优化的系统主体，明确主体关联，定性定量分析基层医疗机构服务能力优化机制，对机构服务能力的模拟政策预期效果进行仿真预测，寻找能力优化的关键控制要素及政策作用靶点，为国家基层医疗机构改革政策体系的制定提供依据和参考。