通讯作者: 吴华章, wuhuazhang1962@126.com

DOI：10.12201/bmr.202508.00042

Theme identification and evolution analysis of the reform policy of compensation mechanism in public hospitals since the new medical reform

• 摘要：目的：分析新医改以来我国公立医院补偿机制改革政策主题的分布特点及演化趋势，为正确认识公立医院补偿机制改革的基本内涵和外延提供参考。方法：收集国家层面出台的75份文件，利用BERTopic主题模型进行主题识别，利用BERTopic动态主题建模方法进行政策演化分析。结果：新医改以来公立医院补偿机制改革政策可分为加强公立医院运营管理、调整医疗服务价格等8个主题，并呈现出初期强调控制医疗费用过快增长和落实政府投入责任、中期聚焦取消药品加成和调整医疗服务价格、后期强化医保支付方式改革的演化趋势。结论：公立医院补偿机制改革本质上是公立医院运行机制的系统性重构，而调整优化医疗服务价格和改革医保支付方式是完善公立医院补偿机制的关键和重点。

  关键词： 公立医院；补偿机制改革；BERTopic模型；政策文本分析

   

  Abstract: Objective: To analyze the thematic distribution characteristics and evolution trends of the compensation mechanism reform policies for public hospitals in China since the new medical reform, and to provide references for correctly understanding the basic connotation and extension of the reform of compensation mechanism. Method: A total of 75 documents issued at the national level were collected. The BERTopic topic model was used for thematic identification.The dynamic topic modeling method of BERTopic was adopted to conduct policy evolution analysis. Result: Since the new medical reform, the reform policy of compensation mechanism in public hospitals can be divided into eight themes, such as strengthening the operation management of public hospitals and adjusting the price of medical services.It shows an evolutionary trend of emphasizing the control of excessive growth of medical expenses and the implementation of government investment responsibilities in the early stage, focusing on the elimination of drug additions and the adjustment of medical service prices in the middle stage, and strengthening the reform of medical insurance payment methods in the later stage. Conclusion: The reform of the compensation mechanism for public hospitals is essentially a systematic reconstruction of the operation mechanism of public hospitals. Adjusting and optimizing medical service prices and reforming the medical insurance payment method are the key and focus of improving the compensation mechanism for public hospitals.

  Key words: Public hospitals；Compensation mechanism reform；BERTopic model；Policy text analysis

  提交时间：2025-08-22

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2025-06-22	bmr.202508.00042V1	下载

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