A longitudinal case study on the dynamic evolution of rural family doctor contract service mode
10.3969/j.issn.1674-2982.2025.06.007
- VernacularTitle:农村地区家庭医生签约服务模式动态演进的纵向案例研究
- Author:
Ya-yan TIAN
1
;
Ting-hui LIAN
;
Xin-yu SHI
;
Jian-tao LI
Author Information
1. 山西医科大学管理学院 山西 太原 030001
- Publication Type:Journal Article
- Keywords:
Family doctor contracting service;
Dynamic evolution;
Longitudinal case study;
Grounded theory;
Rural areas
- From:
Chinese Journal of Health Policy
2025;18(6):51-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the development context and evolution mechanism of family doctor contract service mode in rural areas,and provide reference for relevant departments to continuously optimize the family doctor contract service policy.Methods:Based on the principle of theoretical sampling,J City in S Province,which is listed as one of the national primary health comprehensive pilot areas,was selected as the case study object,and the data were collected through interviews and literature review,and then grounded and coded with NVivo11 software.Results:74 initial concepts,24 sub categories and 9 main categories were sorted out,and the core categories were formed through selective coding.The signing service of family doctors in rural areas has gone through three stages:individual signing of rural doctors,team signing and team signing under the county medical community.Its evolution conditions have gone through the formalization of signing,service capability and efficiency synergy in turn.The three elements of the system adaptation action successively presents differential execution under the system de embedding,collaborative block under the structure embedding and collaborative execution under the system coupling,so as to gradually realize the system coupling from responsibility construction to ability improvement,and then to responsibility,ability and interest.Conclusion:the evolution mechanism of the contracted service mode of family doctors in rural areas reflects the dynamic adaptation under the conditions of political situation,social situation and policy situation,and gradually realizes the closed-loop of the three elements of responsibility,ability and interest based on the differentiation of the three elements of the system.
