三明市老年人健康管理协同治理现状及其障碍因素分析OA

Objective To systematically evaluate the current status of collaborative governance in elderly health management within the context of the Sanming healthcare reform,identify the core obstacles constraining its governance efficiency,and provide a reference for improving the elderly health management model.Methods Based on an evaluation index system for collaborative governance in elderly health management,a questionnaire survey was conducted among staff of integrated health communities and elderly residents in Yong'an City,Mingxi County,and Datian County of Sanming City.Descriptive statistics were employed to analyze the current governance status,and an obstacle degree model was constructed to rank the factors affecting the level of collaborative governance.Results The total score for collaborative governance in elderly health management in Sanming City was 55.11±5.92,indicating a stage of"emerging effectiveness".Scores varied across dimensions,with collaborative motivation and collaborative resources scoring relatively high,while collaborative action lagged behind.Obstacle degree analysis revealed that"performance appraisal mechanism"and"elderly satisfaction"were the primary obstacle factors restricting the improvement of governance capacity,reflecting a structural disconnect between macro-level system integration and micro-level service delivery.Conclusions The administrative-led integration model in Sanming City has demonstrated notable effectiveness in resource allocation and political mobilization;however,bottlenecks persist in achieving deep collaboration and stimulating endogenous motivation.Future efforts should focus on refining an incentive-compatible joint performance system to achieve a transition from administrative integration to value-based collaboration.