【作者】 颜建华；

【导师】 冷荣新；

【作者基本信息】 山东省医学科学院 ， 情报学， 2010， 硕士

【摘要】 目的:通过对不同国家医疗卫生服务体系中组织建设相关资料进行检索、收集和情报学分析,概括当前卫生组织建设与发展研究的理论与实践经验,总结卫生行政组织和卫生服务组织研究的主流内容和热点问题、研究趋势,获取国际卫生发展过程中组织建设与发展的事实和政策依据,为医疗卫生服务体系的组织建设和发展提供决策参考。方法:根据研究目的和资源可及性,在选定的国内外数据资源中进行文献检索,收集整理原始文献,利用文献计量学中的数量统计、共词分析等情报学方法,采用Endnote、汤姆逊分析家分析软件和SPSS统计软件等三种分析工具对最终确定的国内外医疗卫生服务体系中组织建设相关资料进行外部特征和主题分析,并结合卫生政策领域专业知识对资料内容进行系统分析。结果与结论:1、总体情报学分析结果:文献计量学分析结果表明,组织领域国际卫生发展研究较为活跃的国家大多分布在欧美地区,特别是权威研究机构及高产研究机构多集中在美国、英国、加拿大、澳大利亚等国,亚非国家相对少些。针对组织领域的国际卫生研究的需求具有普遍性;组织领域的卫生发展研究历史已久但近30年尤其活跃;研究内容上组织领域国际卫生发展资料的主题广泛、分散而又有相对交叉。不同时间段的情报学分析结论:1950-1979年间的研究热点为医院管理和公共卫生管理,研究主题总体呈现分散趋势;1980-1989年间的研究热点为医院管理、员工管理和医院重组,组织创新成为新兴热点,部分主题间相关性较强;1990-1999年间医院管理热点强度开始减弱,卫生服务改革、全面质量管理、组织模型、医院重组、卫生服务组织成为主要研究热点,主题分散更加明显;2000至今的研究热点依然是医院管理,但全面质量管理、卫生服务改革、卫生服务组织、组织模型、公共卫生管理和组织效率成为新研究热点。2、卫生组织架构领域研究发现:卫生保健与食品与药品监管、社会保障(医疗保险)一体化管理趋势明显;政府卫生行政管理职能应更多的移向更宏观层面的政策与规制的制定与管理,机构准入、人员选拔、信息收集与传播、财政与立法等,对卫生服务组织的具体管理则逐步弱化;私立卫生服务组织在争议中不断成长壮大已成为普遍性事实,甚至已成为公共卫生产品的重要提供者;与卫生组织相关的第三方组织和创新性卫生服务管理组织成为研究者关注的热点。3对卫生组织绩效、策略与变革领域的研究发现:组织绩效与策略研究已成主流内容和热点问题,组织变革研究发展势头强劲;组织绩效领域的定量研究和精准化、数字化研究倍受推崇;卫生组织适应社会经济发展出现的新问题成为组织策略研究的重要内容;组织变革研究文献数量虽少但热点内容较多,其中不乏值得参考借鉴之处。更多还原

【Abstract】 Objective: To retrieve, collect and intelligence analyze the literature of organizations of health service system in different countries, generalize the theory and practical experiences of health organizations construction and development study. To summary the research trends, mainstream and hot issues of health administrative organizations and health service organizations studies, get the facts and the policy basis of organizations construction and development in the world for the health service system building and development decision making.Methods: According to research purposes and resource availability, literature retrieval was used in the original documents collected within selected data resources of domestic and international. Quantity statistics and co-term analysis of bibliometrics methods as well as Endnote, Thomson Data Analyzer and SPSS statistical software were used to analyze the external features and subjects of determined organizations construction materials of health service system in the world, and health policy and professional knowledges were also used to system analysis material content.Results and Conclusions: 1. General results of intelligence analysis: bibliometric analysis shows that studies of health organizations development in the world were mostly found in Europe and America, especially the authority of research institutions and high-yield institutions more concentrated in developed countries, such as the United States, Britain, Canada, Australia, countries of Asian and African were relatively less. Research needs of health organizations in the world are universal; The study of health organiaztions development has a long history especially active in recent 30 years; The contents of health organiaztions development materials are widely scattered and there are relatively cross. Intelligence analysis results of different period: From 1950 to 1979, the hot issues are hospital administration and public health administration, and the overall theme of reseachs show scattered tendency; From 1980 to 1989, hot issues are hospital administration, personnel management and hospital restructuring, and organizational innovation became a new hot issue, some of the theme shows strong correlation; From 1990 to 1999, studies on hospital administration began to weaken, health care reform, total quality management, organizational models, hospital restructuring and delivery of health care organization add to the hot issues, the scattered tendency of the theme is more obvious; From 2000 to date, hospital administration remains the hot issue, but proportion of total quality management, health care reform, delivery of health care organization, organizational models, public health administration and organizational efficiency becoms larger.2. Founds of health organization structure studies: The trend of integrated management health care and food and drug administration, social security (health insurance) is clearly; Government health administrative functions should be towards macroscopical fields, such as policy and regulations formulation and management, institutional access, personnel selection, information gathering and dissemination, financial and legislation and so on, the specific management of health service organizations should be gradually weakening; The group of private health institutions is growing srtonger in the dispute has become a universal reality, and even as an important provider of public health products; The third-party organizations and innovative health care management organizations related to health organizations become focus of researchers attention.3. Founds of health organization performance, strategy and reform studies: Organizational performance and organizational strategy has become the hot issues and mainstream of the health organization study, there is a strong momentum on organizational reform research; Quantitative research, accurate and digitization in health organization performance studies are highly respected; The new problems appear during health organizations adapting to the social and economic development become an important part of the organizational strategy studies; Although the number of organizational reform literatures is small, many of them are worthy of reference to learn from.更多还原