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技术与治理互嵌视角下远程医疗赋能基层高血压管理:一个分析框架

Empowering primary hypertension management through telemedicine from technology-governance embeddedness perspective: An analytical framework

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【作者】 李忠; 冯伟燕; 周辰宇; 蒋明珠;

【Author】 LI Zhong;FENG Wei-yan;ZHOU Chen-yu;JIANG Ming-zhu;School of Health Policy and Management, Nanjing Medical University;Laboratory of Digital Intelligence and Health Governance, Nanjing Medical University;School of Health Economics and Management, Nanjing University of Chinese Medicine;Research Center for Major Health Risk Management and Traditional Chinese Medicine Policy;

【通讯作者】 蒋明珠;

【机构】 南京医科大学医政学院; 南京医科大学数智技术与健康治理实验室; 南京中医药大学卫生经济管理学院; 江苏重大健康风险管理与中医药防控政策研究中心;

【摘要】 数字技术是基层高血压管理的创新驱动力之一。本文基于技术与治理互嵌视角,沿“要素—过程—效能”主线,构建远程医疗赋能基层高血压管理的分析框架。研究发现:(1)技术、功能、应用与结构要素嵌入推动服务场域适配;(2)结构性调整、社会互动重构与制度再生产引领多学科团队、激励机制和协同共治体系的设计与实施;(3)效果主要包括供方指南实施行为、患者依从性、服务利用、费用和健康结局等指标改善。赋能过程本质是技术与治理体系融合下的服务模式重构,关键在于技术与治理情境的充分适配和协同优化。因此,需充分考虑数字技术嵌入与慢病服务体系优化间的协同治理,共同推动服务模式重构、多主体行为改变和患者健康结局改善。

【Abstract】 Digital technology has become an innovative driving force in the management of hypertension at the primary care level. Based on the perspective of technology-governance embeddedness and the thread of "elementsprocess-effectiveness", this paper constructs an analytical framework for telemedicine-enabled hypertension management in primary cares. The study found that:( 1) the embedding of technology, functions, applications, and structures promotes the adaptation of service fields.(2) Structural adjustments, the reconstruction of social interactions, and institutional reproduction guide the design and implementation of multidisciplinary teams, incentive mechanisms, and collaborative governance systems.(3) The outcomes primarily include improvements in indicators such as providers’ compliance with guidelines, patients’ adherence, healthcare service use and costs, and health outcomes. The essence of the enabling process is the reconstruction of service models through the integration of technology and governance systems, with the key lying in the sufficient adaptation and synergistic optimization between technology and governance contexts. Therefore, it is necessary to fully consider the collaborative governance between digital technology embedding and the optimization of chronic disease service systems, jointly promoting the reconstruction of service models, changes in multi-actor behaviors, and improvements in patient health outcomes.

【基金】 教育部人文社会科学研究青年基金项目(23YJCZH114)
  • 【文献出处】 中国卫生政策研究 ,Chinese Journal of Health Policy , 编辑部邮箱 ,2025年12期
  • 【分类号】R544.1
  • 【下载频次】90
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