随着数字化建设推动，深圳市基层健康服务协同治理和城市医疗集团正逐步朝着价值导向型的整合医疗迈进，B医疗集团数字化建设开拓了典型路径。本研究旨在探讨数字技术如何影响医联体协同治理能力，并从理论脉络与深圳实践出发，为城市紧密型医疗集团提供创新前行路径。基于此，本研究提出的关键问题是“在运用数字化推动城市紧密型医疗集团的情境下，以患者为中心构建的协同治理要素是什么，如何真正实现数字化协同？”本研究采用深入访谈、参与式观察、问卷调查等方法。在文献综述基础上，先后对18位实践者与专家学者进行深入访谈，并对典型案例开展为期5个月的参与式观察，结合面向90名医疗集团员工进行的问卷调查，循序渐进地针对研究问题得出研究答案：（1）分析数字化对医疗组织协同服务能力影响主要因素；（2）研究数字技术对紧密型城市医疗集团的主要影响机制；（3）针对基层健康服务协同的中、微观层面问题，提出发展建议。本研究构建了城市紧密型医疗集团的数字化协同理论模型，初步解释了数字化对目标战略、技术资源、制度标准与价值文化等要素的影响，并探索出协同治理模式形成的路径。主要研究结论包括：第一，在基层健康服务治理中，城市紧密型医疗集团通过数字化转型的实践成为推动互联互通与服务协同的关键路径；第二，数字化建设认同度与数字化协同治理能力显著相关，且能够充分提升目标战略协同、制度标准协同、价值文化协同能力，适应力在其中起部分中介作用；第三，组织内部的数字化环境适应能力与数字化进展密切相关，影响适应力的关键因素包括适时的技术、筹资与服务模式创新。本研究的主要贡献包括两个方面。其一，整合“数字转型”和“价值整合”等相关概念，从多维度提出了关于城市紧密型医疗集团数字化协同的解释框架，阐释了数字化转型及应用于基层健康服务的协同治理机制，丰富了现有知识体系；其二，从员工视角揭示了数字化进程如何影响医联体协同治理，强调了“以患者为中心”的模式转型，提出了数字化与医联体协同治理转型新的解释逻辑和具体实践策略，为未来具体城市紧密型医疗集团的高质量协同实践提供了现实路径参考。本研究具体内容有助于拓展城市紧密型医疗集团数字化协同治理的理论与实践研究。
Digitalization is driving the development of value-oriented integrated medical services in Shenzhen, with research on its impact on medical alliance collaborative governance being limited. This study explores the key elements of patient-centered collaborative governance in digital period and how to truly achieve digital collaboration in Integrated Delivery System.Drawing from the literature review and grounded theory discussions, this study investigated the influence of digitalization on urban compact medical consortia. It examines the interactive relationship between employee recognition, environmental adaptability, digital progress, and effectiveness during the digitalization process. The research methodology included in-depth interviews with 18 practitioners, experts and scholars, five months of participatory observation of typical cases, and a questionnaire survey of 90 medical group employees. This study constructed a digital collaboration theoretical model for urban compact medical consortia, elucidating the formation path of synergy governance elements, such as goals strategic synergy, technological resource synergy, institutional standard synergy, and value-based culture synergy under digitalization‘s influence.The main research conclusions are as follows: The degree of recognition for digital construction is significantly related to synergy governance capacity, enhancing goal strategic synergy, institutional standard synergy, and value-based culture synergy. Technology resource collaboration plays a critical role in promoting internal collaboration and resource sharing within medical groups. The overall environmental adaptability of an organization is closely related to digital progress, positively affecting synergy governance capacity. This study integrates concepts like "digital transformation" and "value integration", proposing a multi-dimensional explanatory framework for digital collaboration in compact medical consortia. It uncovers how the digitalization process affects synergy governance from the employee perspective and emphasizes a "patient-centered" model transformation, expanding both theoretical and practical research on digital synergy governance in urban compact medical consortia.
