【中图分类号】R36【文献标识码】A DOI：10.12114/j.issn.1007-9572.2024.0480

【Abstract】Background China is increasingly emphasizing the prevention and control of chronic diseases，with the number and varietyofrelated policies showing a growing trend. Withthe intensificationof populationaging，multimorbidity hasbecomeacriticalchallngeinthefieldofpublichealth，ncessitatingtheurgentoptimizationofrelevantpolicies.ObjectiveThis studyaims torevealthecharacteristicsandpriorityareas ofchronicdisease policiesandidentifypotentialdirections for policyimprovement.MethodsBasedonathree-dimensionalframework of policytols，policyevolution，and policyactors， contentanalysis wasconducted using NVivo 20.O software toencode andclasifyrelevant policydocuments issued fromJanuary 2009 to January2O24.Social network analysis was applied using Ucinet 6.0 software to examine thecollboration network among policyactors，andstatisticalanalyseswereperformedusingExcel2O21.ResultsAnalysisofthe68 included policydocuments identifiedatotalof279references topolicytolusage，comprising35instancesofsupplysidetols，27instancsofdemand sidetools，and117instanesofenvironmentalools.TheGeneralOffceoftheStateCouncilaccountedforthehighestproportion of policy tool references（ 35.48% ，99/279），while the National People's Congress（NPC）and its Standing Committee accounted for the lowest （ 2.87% ，8/279）. In the social network analysis，the collaboration network density among policy actors was0.631，withtheNationalHealthCommisioexhibiting thehighestcentrality.Furtheranalysisofthe68policiesrevealedan increasing trendinboththenumberandvarietyofpolicytolsaspolicies evolved，thoughsuply-sidetoolsremainedpredomnant （35 policies）.TheNPCanditsStandingCommiteewere involvedinrelativelyfewpolicies（3policies）.Moreover，only10 outofthe68policiesaddressedmultimorbidity.ConclusionTheresultsindicatestructural imbalances intheuseofpolicytools andinsuffcientcollaborationamongpolicyactors.Thenumberofpoliciesaddressing multimorbidityislimited，andspecialized policies inthisareaarelacking.Toaddressthechallengesofchronicdiseasepreventionandcontrol，itisrecommendedto optimizethe alocationof policytols，enhancecoodination among policyactors，and promotethedevelopmentof specialized policiesformultimorbidity.Expandingpolicycoverageandtransitioningfromasingle-disease managementmodel toanintegrated multimorbidity managementapproachare esential tocomprehensivelystrengthenthecapacityforchronic disease preventionand control.

【Key words】 Chronic diseases；Multimorbidity；Policy instruments；Social network analysis；Policy text analysis

《“健康中国2030”规划纲要》明确提出“实施慢性病综合防治战略”的行动方针，凸显了我国对慢性病防治工作的高度重视[]。值得关注的是，多重慢病已成为慢性病发展过程中的显著特征之一[2]。多重慢病指的是个体同时罹患2种及以上慢性疾病[3]。随着人口老龄化程度加深，老年人多重慢病现象日益普遍，已逐渐演变为公共健康领域所面临的关键挑战[4]。全球65 岁及以上老年群体中多重慢病患病率为 40%～56% 。而在卫生管理领域，国内对老年人多重慢病的研究主要集中在综合评估、疾病管理以及医养结合等方面，缺乏基于政策工具视角的政策文本分析研究[]。政策工具作为一种研究公共政策的有效手段，被广泛应用于医疗卫生方针政策领域［7-8]。本研究先检索并分析慢性病防治政策，然后对多重慢病政策加以分析，基于政策工具、政策演进、政策主体3个维度对我国68份慢性病（含多重慢病）防治政策文本深人剖析，旨在探究我国当前慢性病防治政策特征、重点领域以及潜在不足，以期为慢性病防治政策的改进和优化提供可行建议。

1资料与方法

1.1 资料来源

本研究以“慢病”“共病”“慢性病”“多重慢病”

等为关键词，访问国务院、国家卫生健康委员会、农业农村部、全国人民代表大会及其常务委员会等相关部委官方网站及北大法宝数据库。采用全文模糊检索方式检索，以2009年新医改作为研究年份起始点，检索2009年1月一2024年1月发布的相关政策文件。……