Policy evaluation of human organ transplantation based on policy modeling consistency index model
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摘要:
目的 对我国人体器官移植政策进行评价，为进一步优化人体器官移植政策提供理论依据。 方法 基于文本挖掘与统计分析法，通过构建政策一致性指数模型（PMC），并通过10个一级变量和35个二级变量对2000年至2022年国家政府层面制定的7项人体器官移植规范性政策进行量化评价。 结果 在7项政策中，6项为优秀型政策，1项为完美型政策，平均PMC指数达8.476。除X8政策受体外，P5其他二级变量得分都高于或等于均数；P1各项二级变量得分都低于或等于均数。P1和P5在X3政策时效、X4政策规范和X6政策工具方面均有显著不同，P5在这些方面都更加具体且相对全面，因此得分显著高于P1。 结论 我国人体器官移植政策总体上优秀且科学合理，建议今后各级卫生健康行政部门在出台器官移植相关政策时，应注意政策时效的把握，注重政策工具的组合，充分调动各政策受体参与器官移植管理的工作主动性和积极性。 Abstract:Objective To evaluate the policy of human organ transplantation in China, aiming to provide theoretical basis for further optimizing the policy of human organ transplantation. Methods Based on text mining and statistical analysis, seven normative policies of human organ transplantation formulated by national government from 2000 to 2022 were quantitatively evaluated by constructing policy modeling consistency (PMC) with 10 first-level variables and 35 second-level variables. Results Among the seven policies, six were graded as excellent policies and one as perfect policy, with an average PMC index of 8.476. Except X8 policy audience, the scores of other second-level variables of P5 were higher than or equal to the mean. The scores of all second-level variables of P1 were lower than or equal to the mean. P1 and P5 significantly differed in X3 policy timeliness, X4 policy norms and X6 policy tools. P5 was more specific and relatively comprehensive in these aspects, and its score was significantly higher than that of P1. Conclusions Human organ transplantation policies in China are generally excellent, scientific and rational. Health administrative departments at all levels should pay attention to the grasp of policy timeliness, the combination of policy tools, and fully mobilize the initiative and enthusiasm of all policy audience to participate in organ transplantation management when formulating organ transplantation policies. -
图 1 7项器官移植政策的PMC曲面图
注：A~G图为P1~P7的PMC曲面图。
Figure 1. PMC-surface chart of 7 organ transplantation policies
表 1 器官移植政策样本
Table 1. Samples of organ transplantation policies
政策编号 政策名称 发文部门 日期 P1 卫生部办公厅关于加强人体器官移植数据网络直报管理的通知（卫办医管发〔2010〕105号） 卫生部 2010-06-24 P2 卫生部关于进一步加强人体器官移植监管工作的通知（卫医管发〔2011〕29号） 卫生部 2011-04-08 P3 卫生部办公厅关于启动心脏死亡捐献器官移植试点工作的通知（卫办医管发〔2011〕62号） 卫生部 2011-04-26 P4 卫生部关于依法禁止无人体器官移植资质医疗机构开展器官移植手术的通知（卫医管发〔2012〕11号） 卫生部 2012-02-08 P5 国家卫生计生委关于印发人体器官移植医师培训与认定管理办法等有关文件的通知（国卫医发〔2016〕49号） 国家卫生和计划生育委员会 2016-09-25 P6 国家卫生健康委办公厅关于印发人体器官移植技术临床应用管理规范（2020年版）的通知（国卫办医函〔2020〕705号） 国家卫生健康委员会 2020-08-24 P7 人体器官移植条例（中华人民共和国国务院令〔第491号〕） 国务院 2007-03-31 
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表 2 器官移植政策变量设置
Table 2. Variable setting of organ transplantation policies
一级变量 二级变量 政策性质（X1） 预测（X1:1）、描述（X1:2）、建议（X1:3）、支持（X1:4）、前瞻性（X1:5） 政策功能（X2） 明确权责（X2:1）、规范管理（X2:2）、统筹安排（X2:3）、监督检查（X2:4） 政策时效（X3） 长期（X3:1）、中期（X3:2）、短期（X3:3）、一年内（X3:4） 政策规范（X4） 器官移植（X4:1）、器官捐献（X4:2）、医师培训（X4:3）、技术规范（X4:4）、资质认定（X4:5）、数据管理（X4:6） 政策视角（X5） 宏观（X5:1）、微观（X5:2） 政策工具（X6） 供给型（X6:1）、环境型（X6:2）、需求型（X6:3） 政策评价（X7） 依据充分（X7:1）、目标明确（X7:2）、方案合理（X7:3）、规划可操作性（X7:4） 政策受体（X8） 行政部门（X8:1）、医疗机构（X8:2）、医务人员（X8:3）、患者（X8:4） 政策级别（X9） 国家级（X9:1）、省级（X9:2）、市级（X9:3） 政策公开（X10） /
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表 3 7项器官移植政策的PMC指数
Table 3. PMC index of 7 organ transplantation policies
一级变量 P1 P2 P3 P4 P5 P6 P7 均数 X1政策性质 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 X2政策功能 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 X3政策时效 0.250 0.500 0.750 0.500 1.000 0.500 0.750 0.607 X4政策规范 0.833 0.500 1.000 0.500 1.000 1.000 0.833 0.809 X5政策视角 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 X6政策工具 0.667 0.667 1.000 1.000 1.000 1.000 1.000 0.905 X7政策评价 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 X8政策受体 0.750 1.000 0.750 0.750 0.750 1.000 0.750 0.821 X9政策级别 0.333 0.333 0.333 0.333 0.333 0.333 0.333 0.333 X10政策公开 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 PMC指数 7.833 8.000 8.833 8.083 9.083 8.833 8.666 8.476 排名 7 6 2 5 1 2 4 政策效果 优秀 优秀 优秀 优秀 完美 优秀 优秀 优秀
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