家庭医生签约服务政策扩散的多维演进机理分析
Multi-Dimensional Evolutionary Mechanism Analysis of the Diffusion of Family Doctor Contracted Service Policy

新发展阶段下，我国医药卫生事业正面临着人口老龄化加剧、各类慢性疾病高发等诸多挑战，以医院为中心的医疗卫生服务模式难以满足群众对长期、连续健康照护的需求。家庭医生签约服务政策的推行，为满足公众医养需求、促进医药卫生事业可持续发展奠定了关键基础。通过运用关键词时序分析法和词频分析法对该政策进行的量化文本分析，可以发现其在时间、空间、方向和内容四大维度分别呈现出了不同的演进特征：1) 在时间维度上呈现出多点带面的“反R型”曲线扩散态势；2) 在空间维度上邻近效应与层级效应并存；3) 在方向维度上平行扩散和垂直吸纳并进；4) 在内容维度上表现为五维主题下的知识生产。对该政策扩散的演进机理分析能够为家庭医生签约服务政策迈向高质量发展阶段提供阶段性总结。
In the new stage of development, China's medical and health care is facing many challenges, such as the increasing aging of the population and the high incidence of various chronic diseases. The hospital-centered medical and health service model is difficult to meet the public's demand for long-term and continuous health care. The implementation of the family doctor contracted service policy has laid a key foundation for meeting the public’s medical and nursing needs and promoting the sustainable development of medical and health care. By using the keyword sequence analysis method and word frequency analysis method to conduct quantitative text analysis of the policy, it can be found that it shows different evolutionary characteristics in the four dimensions of time, space, direction and content: 1) In the time dimension, it shows a multi-point and surface “reverse R” curve diffusion trend; 2) In the space dimension, the adjacent effect and hierarchical effect coexist; 3) In the direction dimension, parallel diffusion and vertical absorption go hand in hand; 4) In the content dimension, it is represented by knowledge production under the five-dimensional theme. The analysis of the evolutionary mechanism of the policy diffusion can provide a stage summary for the family doctor contracted service policy to move to the stage of high-quality development.