| Objective:In this study,the knowledge map and word frequency statistics are used to dig out effective information,which clearly and intuitively reflects the relevant situation in the research field of hierarchical diagnosis and treatment at home and abroad.At home and abroad based on the classification to specific clinical research data analysis and comparative study,found the differences and similarities existing in it and to explore the reasons.It is helpful to grasp the overall situation,research frontiers and hot spots of graded diagnosis and treatment research at home and abroad,clarify the research ideas in this field,provide reference for predicting the future research trend of China’s graded diagnosis and treatment research,and provide guidance for the research of China’s medical service system.Methods:All of the literatures about the domestic and foreign medical service systems are downloaded from CNKI,Wanfang,VIP and Pub Med databases.Domestic data were subject searched with "hierarchical diagnosis and treatment" as the search term,while foreign data were subject searched with "health service system" as the search term,and relevant literatures were found by constructing search strategies such as "State Medicine" [Mesh] OR "National health system" [Mesh].The domestic data includes two parts: one is related papers published in domestic journals;The second is related papers published by Chinese institutions in foreign journals.High frequency keywords in literature were extracted as research objects.The data of Chinese and foreign hierarchical diagnosis and treatment were analyzed and compared by using knowledge mapping methods such as co-word clustering analysis and social network analysis and word frequency analysis.Results:First of all,in terms of the amount of published papers,the overall trend of graded diagnosis and treatment research at home and abroad is on the rise,and shows a close connection with ethical research.China started in 1989,45 years later than foreign countries,and the number is also small,but China’s rapid development.Then,in terms of network structure,the research subjects of hierarchical diagnosis and treatment in China present a trend of large structure being significant and small structure being compact.Foreign studies show a diversified structure,and the subject of the complex situation.The average path length of foreign research network is smaller than that of domestic research network,and the cohesion index of foreign research network is0.901,which is closer to 1 than that of domestic research network,indicating that foreign research network is closer than that of domestic research network.Third,in terms of research topics,domestic and foreign scholars have paid attention to the basic research of medical service system,medical cost control research and chronic disease epidemiology research.In addition,the research on disability and pension service system and oral health care service are also studied abroad.Last but not least,in terms of research contents,researchers at home and abroad focus on both similarities and differences.The similarities are as follows: both Chinese and foreign basic researches on graded diagnosis and treatment have studied the important roles of medical reform,medical insurance and medical institutions in the construction of medical service system,and paid attention to the research on ethical issues involved in medical services.Meanwhile,a consensus has been formed in the research on medical cost control.The differences are mainly reflected in:(1)Chinese scholars mostly study the system and system problems of hierarchical diagnosis and treatment,while foreign studies have gone down to the internal organization of medical service system and other aspects.(2)In terms of the research on ethical issues in hierarchical diagnosis and treatment,European countries led by the United Kingdom attach great importance to the management and safety of medical data,while American countries mainly focus on the research on the fairness and accessibility of social welfare and health services,while China has a wide range of research.(3)China attaches great importance to the relationship between disease prevention,medical care and medical cost control,and focuses on the mortality and risk factors of chronic disease epidemiology.(4)The foreign classification diagnosis research has three important characteristics: in the study of medical expense control attaches great importance to the ethical problems in emergency medical services,from the perspective of national strategy and the construction of ethical conduct slow disease epidemiological studies,as well as the disabled and pension service in grading deep going and systematic in the study of diagnosis and treatment system.Conclusion:1.Domestic and foreign researchers have conducted in-depth and continuous research on hierarchical diagnosis and treatment.2.The overall network of graded diagnosis and treatment research in foreign countries is more cohesive than that in China.The research network of hierarchical diagnosis and treatment in China is relatively single in subject content,while the research network of foreign countries is complex and closely connected.3.Domestic and foreign scholars share common concerns in the study of hierarchical diagnosis and treatment,and at the same time,many characteristic studies have been formed in foreign studies.4.Domestic and foreign scholars are aware of the important role of basic research and ethical research in the research of medical service system.In the specific subject research,domestic and foreign research has its own characteristics,but foreign research is more detailed.Advise:Research on hierarchical diagnosis and treatment in China should be more continuous and detailed,so as to focus on specific subject areas and sink the research topic.A comprehensive and systematic analysis of the research on hierarchical diagnosis and treatment in China,combined with the relevant experience of foreign research,finally formed the characteristics. |
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