【中图分类号】 R 197 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2024.0271

【Abstract】BackgroundWith the comprehensive launch of the information construction of China’s close-knit county-levelmedicalconsortium，localitiesaremakingfulluseof Internet information technologytoexplore mechanisms suitableforthedevelopmentofcounty-levelmedicalconsortium，andhowtorelyoninformationtechnologyconstructionto enhance thecapacityof primary healthcare services has becomean important isse.ObjectiveExplore the mechanismof informationconstructiontoempowerthehigh-qualitydevelopmentofcompactmedicalconsortium.MethodsPurposivesampling method wasusedtoconductsemi-structured interviews in December2O23with28 medical staffromthe medicalcommunity inCountyG.Theinterviewtopicscenteredonthecharacteristicsandhighlightsofthemedicalcommunityintheconstruction of informationtechnology，itseffectiveness，andtheapplicationof information technologyintheinternal managementofthe medicalcommunity，etc.Atthesametime，policydocumentsand newsreportsontheconstructionofthecounty-level medicalcommunitywereselectedtoserveas thesecondarydata.Theinterviewdataandsecondarydatawerecodedandanalysed throughopencoding，axial coding and selective coding，folowing programmed roting theory approach.ResultsThrough open coding，134 conceptsand 48 basic categories were extracted；6 main categories were obtained through axial coding. Theoreticalframework wasformed through selectivecoding，which mainlyconsistsof4 mechanisms，theywerethe mechanism of top-down linkage，the mechanismofintegrationof medicaltreatmentandprevention，themechanismofdatasharing，the mechanism offund management.ConclusionCountyGmedicalconsortiumimproves thetop-leveldesignand strengthens the unifiedmanagementandresponsibilityimplementationof the medicalconsortium；andempowersthedivisionoflabor，service integration，interconnectionandbenefit-sharingmechanismamongunitsofthecompactcounty-levelmedicalconsortiumtrough informatization，soas to promote the high-quality development of the compact county-level medical consortium.

【Key Words】Compact county-level medical consortium；Hierarchical diagnosis and treatment；Information technology；Qualitative research；Grounded theory

开展紧密型县域医共体建设是强化基层医疗卫生服务的重要举措，随着数字化信息技术的蓬勃发展，医疗信息化建设成为县域医共体高质量发展的重要驱动力［1]。2020年9月国家卫生健康委发布《紧密型县域医疗卫生共同体建设评判标准和监测指标体系》，指出评判标准由责任、管理、服务、利益共同体4个维度构成，要求各地加强信息互联互通，强化建设评判标准和监测指标数据质量管理[2］。2021年《国务院办公厅关于推动公立医院高质量发展的意见》［3］和《关于印发公立医院高质量发展促进行动（2021—2025年）的通知》［4]先后发布，提到要强化信息化支撑作用，推进医院信息化建设标准化、规范化水平。2023年12月国家卫生健康委发布《关于全面推进紧密型县域医疗卫生共同体建设的指导意见》，提到要加强数据互通共享和业务协同，统一县域医共体内信息系统［5］。信息化建设是理顺协同治理秩序的重要工具[，在由单个机构的发展转向县域医疗卫生体系整体发展进程中具有重要地位，政府应当密切关注并积极参与到信息化建设进程中，采取实时监督的方式推动信息化建设的深人实施[]。但目前，我国县域医共体信息化建设存在政府主导与监督力度不足、基础信息系统薄弱和区域内信息平台无法联通[8]，业务对接和数据共享未实现全面畅通[9]等问题，在很大程度上限制了医疗资源的使用效率和健康管理能力的提升。此外，卫生资源配置结构性失衡问题由来已久，不同等级医院之间相互割裂、分工合作关系难以形成。……