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推进检查检验结果共享互认是缓解医疗资源重复消耗、提升老龄社会医疗服务效率的重要制度安排，但实践中长期存在“不能认、不敢认、不愿认”的现实困境。以重庆市“渝悦·医检互认”为例，基于复杂适应系统理论，提出“适应性环境设计”视角，构建“数据—流程—责任—激励”的四维框架剖析其生成机制。研究发现，针对实践中面临的数据割裂、流程阻滞与风险约束等问题，通过数据聚合降低信息不确定性，流程整合重塑行为路径，责任重构缓释风险预期，激励相容推动利益契合，四者协同促进医检互认由“制度驱动”向“行为内生”演化。同时，提出未来应由结果共享向决策支持延伸，构建流程智能化、风险系统化分担及价值再分配的演化路径，推动医疗治理由信息互通向认知协同与治理结构优化跃迁。
Abstract：Promoting the mutual recognition of medical test results is an important institutional arrangement for alleviating the repeated consumption of medical resources and improving the efficiency of medical services in an aging society. However,in practice, it has long faced the realistic dilemma of “ cannot recognize, dare not recognize, and unwilling to recognize. ”Taking Chongqing's “Yuyue · Medical Test Mutual Recognition” as an example and based on Complex Adaptive Systems( CAS)theory, this paper proposes an “ adaptive environment design” perspective and constructs a four-dimensional framework of“data—process—responsibility—incentive” to analyze its generation mechanism. The study finds that, in response to problems such as data fragmentation, process obstruction, and risk constraints in practice, data aggregation reduces information uncertainty, process integration reshapes behavioral paths, responsibility reconstruction mitigates risk expectations, and incentive compatibility promotes the alignment of interests. The coordination of these four aspects facilitates the evolution of medical test mutual recognition from “institution-driven” to “behavior-endogenous. ” At the same time, it is proposed that in the future, the sharing of results should be extended to decision support, and an evolutionary path of intelligent processes,systematic risk sharing, and value redistribution should be constructed, so as to promote the transition of medical governance from information interoperability to cognitive coordination and governance structure optimization.
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基本信息:
DOI：10.14134/j.cnki.cn33-1337/c.2026.04.013
中图分类号:D669.6;R-05
引用信息:
[1]周学馨,吴波.数智医疗的适老化治理：基于CAS视角的医检互认生成机制研究[J].浙江工商大学学报,2026,No.199(04):138-149.DOI:10.14134/j.cnki.cn33-1337/c.2026.04.013.
基金信息:
国家社会科学基金哲学社会科学领军人才项目“积极应对人口老龄化国家战略的制度框架研究”(22VRC102)
2026-08-10
2026
2026-10-09
2026
1
2026-07-15
2026-07-15