Promoting the construction of county-level medical communities is a crucial measure for establishing a hierarchical medical system. While the domestic academic community has conducted extensive theoretical and empirical research in this field, there is a lack of comprehensive summaries of existing research findings. This study uses bibliometric methods to systematically review the progress of related literature in this field, providing insights and references for the high-quality development of county-level medical communities.
To conduct a visual analysis of the literature on county-level medical communities in China, exploring research hotspots and frontier trends in this field.
Using the China National Knowledge Infrastructure (CNKI) database, literature related to county-level medical communities published between 2016 and 2023 was retrieved on February 25, 2024. CiteSpace software was employed for bibliometric visualization analysis of the literature, focusing on publication years, authors and institutions, keyword co-occurrence, clustering, timeline distribution, and burst detection.
A total of 481 articles were included. The publication volume in this field has been increasing, driven by policy factors, with 65 articles (13.51%) published between 2016 and 2019, 167 articles (34.72%) published between 2020 and 2021, and 249 articles (51.77%) published between 2022 and 2023. The top three authors in terms of publication volume were CHEN Yingchun, WANG Fang, and ZHENG Ying, each with 8 articles. The top two keywords in terms of centrality and cluster size are "medical community" and "hierarchical medical system". The timeline distribution indicated that "hierarchical medical system" was the earliest and most sustained research hotspot in this field. Additionally, clusters such as "integration of medical prevention" "performance evaluation" "countermeasures" and "patients" emerged as research hotspots. Burst detection revealed that "medical insurance fund" "chronic disease" "management model" "development strategy" and "rural doctors" were recent research hotspots and future directions in this field.
Key research hotspots in the field of county-level medical communities include the construction of hierarchical medical systems, focusing on chronic diseases and the integration of public health services, and exploring performance evaluation pathways. Future research trends indicate a strong focus on deepening policy research, using county-level medical community construction to promote the establishment of hierarchical medical systems, advancing innovation in the integration of medical prevention, enhancing performance evaluation, and optimizing internal management.
Knowledge sharing of family doctor teams under the county medical community is an important way of interaction between the county and rural institutions, which plays an important role in enhancing the quality of regional medical and health services and improving the health of residents.
To investigate the knowledge sharing among family doctor teams under the county medical community, to explore its influencing factors, and to provide a scientific basis for promoting knowledge management and capacity enhancement within family doctor teams.
From October to December 2022, multistage sampling was used for selecting 381 family doctor teams under two county medical communities were selected as study subjects in Hubei Province using the convenience sampling method, and a self-administered team knowledge-sharing questionnaire was used to investigate the knowledge-sharing level of the included subjects, and multivariate linear stepwise regression analyses were used to explore the influencing factors of the knowledge-sharing of family doctor teams, including two dimensions of explicit knowledge sharing and implicit knowledge sharing.
The total knowledge sharing score of family doctor teams under county medical communities was (27.84±3.84), and the mean item level scores of the two dimensions of explicit and implicit knowledge sharing were (5.51±0.79) and (5.61±0.77), respectively; the results of the multivariate linear stepwise regression analysis showed that the heterogeneity of academic qualifications, intensity of team communication, intensity of team activities, motivation of members to learn, the use of platform carriers, and the team leader's role were the influencing factors of knowledge sharing of family doctor teams under the county medical community (P<0.05) .
Knowledge sharing within the family doctor team under the county medical community is at a good level, and there is still room for improvement. It is recommended to improve the level of knowledge sharing among family doctor team members by increasing the frequency of family doctor team activities, improving the intensity of team communication, adopting relevant incentives, and expanding knowledge sharing channels.
The effectiveness of family physician teams under the county medical community is low, and the current status of team management is not yet clear, the perceived status of team management for members with different characteristics is not yet clear.
To understand the current situation of family doctor team management under the county medical community, and to provide a basis for further refinement and improvement of family doctor team management.
From October to December 2022, a total of 1 724 key members of 429 family doctor teams under the county medical communities in Hubei Province were surveyed using a self-developed questionnaire, which included the management of team configurations, the management of team interactions and the results of team management. Differences in perceptions of team management between family doctor team members with different characteristics were analysed using chi-squared test and ANOVA, and Pearson correlation was used to analysis the correlation between team interaction management and team management outcome factors.
Among 1 724 survey respondents, 62.9% (1 084/1 724) perceived that team assessment and incentive measures were effective, and 88.7% (1 530/1 724) perceived that they had a reasonable allocation of family doctor team personnel. The respondents had a score of (22.3±5.3) for the intensity of internal team interactions and a score of (22.0±5.3) for the perceived intensity of the team's interaction and liaison with the outside. Regarding family doctor team members' perception of team management results, team members' perceived team goal achievement, i.e., team task performance, scored (33.1±7.4), perceived satisfaction with the team scored (22.3±4.9), and perceived team's ability and potential for future development scored (27.9±6.3), while the total scores of the three dimensions were 0-36, 0-24, 0-30. Comparison of team configuration management, team interaction management, and perceptions of team management outcomes between family doctor team members of different positions, titles, and ages showed statistically significant differences (P<0.05). There was a positive correlation between team interaction management factors and team management outcome factors (P<0.05) .
Family doctor team members perceive that team configuration management is relatively good, and there is still room for improvement in team assessment and incentives; family doctor team interactions are better managed, and team interactions play an important role in improving team management results; family doctor team members have a better perception of team management results, and perceive task performance to be lower than satisfaction and development ability; there are large differences in the perceptions of team management among family doctor team members of different positions, titles, and age groups.
