基于三维框架的主动健康政策文本量化分析

A quantitative analysis of proactive health policy texts based on a three-dimensional framework

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。

Abstract

Objective To systematically analyze the structural characteristics and collaborative logic of China's proactive health policy texts, identify existing problems and optimization directions, and provide references for improving the proactive health policy system and enhancing governance efficiency. Methods Using Nvivo 15 software, 50 proactive health policy texts issued at the central level from 2016 to 2024 were coded and analyzed. A three-dimensional analytical framework based on policy instruments, stakeholders, and policy goals was constructed, and content analysis was employed to conduct univariate descriptive statistics and multidimensional cross-analysis. Results In the policy instrument dimension, supply-side (46.76%) and environmental (35.49%) instruments dominated, while demand-side instruments were relatively scarce (17.75%). In the stakeholder dimension, the government (49.08%) occupied a dominant position, with non-governmental organizations severely under-involved (1.74%); the remaining stakeholders, in descending order of participation frequency, were the public (21.21%), healthcare institutions (17.52%), enterprises (5.53%), and research institutions and universities (4.92%). Policy goals were primarily concentrated on optimizing health services (57.14%) and improving public health (29.03%), with relatively weak policy support for accelerating health technology innovation (7.68%), developing the health industry (3.53%), and reducing the medical burden (2.61%). Cross-analysis revealed structural mismatches among policy instruments, stakeholders, and policy goals. Conclusion China's proactive health policies exhibit structural characteristics of being supply-driven, government-centered, and service-prioritized. It is recommended to optimize the policy instrument mix by strengthening demand-side instruments and rigid constraints; establish multi-stakeholder collaborative mechanisms to stimulate market and social vitality; and rebalance policy goal prioritization by addressing disadvantages in areas such as medical burden reduction, thereby advancing the proactive health policy system toward more balanced, efficient, and sustainable development.

关键词

主动健康 / 政策文本 / 政策工具 / 利益相关者 / 政策目标

Key words

Proactive health / Policy texts / Policy instruments / Stakeholders / Policy goals

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基金资助

国家自然科学基金青年项目(72304003)

安徽省教育厅2025年度重大科研项目(2025AHGXSK20022)

安徽省教育厅优秀青年教师培育项目重点项目(YQZD2025020)