Polycentric-collaborative governance framework for county medical communities
10.3760/cma.j.cn111325-20240602-00435
- VernacularTitle:县域医疗卫生共同体多中心协同治理框架的构建
- Author:
Xiaoying PU
1
;
Qian HAO
;
Ping ZHANG
;
Zhuangfei WANG
;
Yaming GU
Author Information
1. 杭州师范大学基础医学院，杭州 311121
- Publication Type:Journal Article
- Keywords:
Governance theory;
County medical community;
Polycentric governance;
Collaborative governanc;
Accountable care organization;
Framework
- From:
Chinese Journal of Hospital Administration
2025;41(1):1-7
- CountryChina
- Language:Chinese
-
Abstract:
County medical community serves as pivotal instruments for the hierarchical diagnostic and treatment system. Since their nationwide implementation in December 2023, there has been a pressing demand for governance theories to direct practical applications. Based on polycentric-collaborative governance theory, this study articulated a framework that modeled county medical community as accountable care organizations, anchored by a foundation of primary health care and a polycentric-collaborative governance structure. The framework encompassed critical dimensions, including problem orientation, diverse governance actors, multi-dimensional governance mechanisms, governance objectives, and evaluative metrics. This research also introduced 17 governance instruments, delineated 13 priority action fields, and pinpointed 5 potential reform areas, with a pronounced focus on bolstering governance capacity through value-based payment reforms and technological underpinnings of digital innovation. The framework′s viability and efficacy have been substantiated through a case study in Zhejiang Province. The framework presented herein could offer a comprehensive and systematic guide for county medical community practice, capturing the essence of the reform through a problem-oriented lens, fostering multi-actor involvement, and ensuring the harmonization of multi-dimensional governance mechanisms, thereby fortifying the reform′s systematic, integrative, and collaborative attributes.
