基于修正后模糊冲突模型的我国门诊共济政策执行困境研究OA

Objective To analyze the constraining factors in the implementation of the outpatient mutual-aid policy in China,aiming to provide a theoretical foundation for optimizing the effectiveness of policy im-plementation.Methods Based on the revised"ambiguity-conflict"theoretical framework,an analytical matrix was constructed for the textual analysis of documents of the outpatient mutual-aid policy and feedback data at the municipal level and above since the 2021 healthcare reform.Results The policy conveyance stage was character-ized by decreasing ambiguity and increasing conflict,prompting political implementation;the policy deepening stage saw a simultaneous reduction in both,shifting the model to administrative execution.Conclusions The cur-rent policy follows an administrative execution model,with resource assurance as its main constraint.The imple-mentation faces challenges such as policy ambiguity,institutional fragmentation,worsening imbalance in resource allocation,tests of legitimacy and effectiveness,and gaps between administrative actions and social demands.To ensure the effective implementation of the outpatient mutual-aid policy,it is suggested to build a collaborative poli-cy adaptation system,innovate financial resource allocation and compensation mechanisms,establish a multi-di-mensional effectiveness assessment system,and create a governance ecosystem that fosters collaboration between government and society.