中国抗菌药物耐药治理政策文本分析：以国家级政策为重点

Policy text analysis of antimicrobial resistance governance in China: A focus on national-level policies.

机构信息

School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, Hubei, China; Major Disciplinary Platform under Double First-Class Initiative for Liberal Arts at Huazhong University of Science and Technology (Research Center for High-Quality Development of Hospitals), Wuhan, Hubei, China.

School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Int J Antimicrob Agents. 2024 Sep;64(3):107286. doi: 10.1016/j.ijantimicag.2024.107286. Epub 2024 Jul 29.

DOI:10.1016/j.ijantimicag.2024.107286

PMID:39084572

Abstract

OBJECTIVE

To explore the structure and characteristics of China's national policies regarding antimicrobial resistance (AMR) governance.

METHOD

This research constitutes a quantitative content analysis of AMR policies issued by the central government from 2004 to 2023. A systematic search identified 112 policy documents, which were analysed using a three-dimensional framework. This framework included policy objectives, policy instruments (The supply-focused instrument aims to promote rational and prudent antibiotic prescriptions. The demand-focused instrument affects consumer use of antibiotics, either directly or indirectly. The environment-focused instrument provides a favourable and systematic policy environment for the prudent use of antibiotics.) and policy evolvement. Sub-themes under the framework were identified through a deductive process, followed by descriptions of frequency distributions of the sub-themes and categories.

RESULTS

The majority of policy documents originated from individual governmental departments, with only 8 (7.14%) being jointly issued. The National Health Commission (NHC) remained the predominant policy maker, issuing 56 (48.21%) policies. A clear preference emerged for utilizing environment-focused policy instruments (69.70%), compared with the demand-focused (18.45%) and supply-focused (11.85%) instruments. 'Optimizing the use of antimicrobial medicines' ranked on top of the policy objectives, with 185 (31.25%) citations extracted across 74 (30.58%) policy documents. In addition to increasing numbers of policies over the three stages (2004-2011, 2012-2015, 2016-2023) of development, the use of various instruments became more comprehensive and balanced in the third stage.

CONCLUSIONS

AMR governance has become increasingly comprehensive in China, despite a deficit in inter-sectoral collaborations. A whole-of-government approach is required to maximize the value of various policy initiatives.

摘要

目的

探索中国国家抗微生物药物耐药性（AMR）治理政策的结构和特征。

方法

本研究对 2004 年至 2023 年中央政府发布的 AMR 政策进行了定量内容分析。通过系统检索，确定了 112 项政策文件，采用三维框架进行分析。该框架包括政策目标、政策工具（供应方重点工具旨在促进合理和谨慎使用抗生素处方。需求方重点工具直接或间接地影响消费者对抗生素的使用。环境方重点工具为谨慎使用抗生素提供有利和系统的政策环境。）和政策演变。通过演绎过程确定框架下的子主题，然后描述子主题和类别频率分布。

结果

大多数政策文件来自个别政府部门，只有 8 份（7.14%）是联合发布的。国家卫生健康委员会（NHC）仍然是主要的政策制定者，发布了 56 项（48.21%）政策。与需求方（18.45%）和供应方（11.85%）工具相比，环境方工具（69.70%）明显受到青睐。“优化抗菌药物使用”在政策目标中排名第一，在 74 份（30.58%）政策文件中引用了 185 次（31.25%）。除了在发展的三个阶段（2004-2011 年、2012-2015 年、2016-2023 年）中政策数量增加外，第三阶段各种工具的使用变得更加全面和平衡。