[
  {
    "id": "ltc",
    "title": "☂️ 长期护理保险",
    "group": "长期照护与养老",
    "definition": "针对失能照护需求的社会保险安排；参保、失能评估、符合待遇资格与实际获得服务须分开。2026建制阶段应与此前试点版本区分。",
    "logic": "筹资与统筹 → 失能评估 → 待遇支付 → 正式照护供给 → 家庭照护与健康/经济结果",
    "clauses": [
      "参保范围、缴费主体与筹资结构",
      "等级、持续失能、评估机构与复评申诉",
      "居家/社区/机构待遇和服务项目",
      "等待、限额、定点、支付与监管",
      "2026建制和原试点过渡"
    ],
    "variables": [
      "地区×版本×不同实施日期",
      "政策前功能/失能与认知",
      "服务可得性、实际利用和家庭照护时间",
      "自付、家庭劳动与健康结果"
    ],
    "questions": [
      "保障扩展能否缓解照护者负担？",
      "同等失能下，城乡或不同参保类型的服务可及性是否不同？",
      "支付激励是否改变居家与机构护理的组合？"
    ],
    "methods": [
      "条款比较与政策工具分析",
      "交错DID/事件研究（实际实施时点）",
      "混合方法与实施/公平评价"
    ],
    "pitfalls": [
      "用试点名单年份替代待遇支付日期",
      "把所有老年人当待遇合格者",
      "将地方比例写成全国统一标准"
    ],
    "source_ids": [
      "ltc16",
      "ltc20",
      "ltc23",
      "ltc25",
      "ltc26",
      "ltc-plan",
      "ltc-local",
      "ltc-sh"
    ],
    "guide": "guides/long-term-care-policy-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "home-bed",
    "title": "🏡 家庭病床",
    "group": "居家医疗与基层",
    "definition": "由医疗机构评估并在符合条件患者居住场所提供连续医疗服务，有建床、责任团队、病历与撤床等要求；不等于所有上门服务。",
    "logic": "申请与评估 → 协议/建床 → 连续服务与监测 → 转诊/撤床 → 结算与质量",
    "clauses": [
      "对象、疾病状态、就医困难与场所条件",
      "机构许可、服务能力与人员资质",
      "建撤床、首次访视、频次与医疗记录",
      "服务价格、医保范围和结算",
      "与家庭医生、养老机构、长护险的衔接"
    ],
    "variables": [
      "机构开办/个人建床日期、床日与访视",
      "功能、病情、照护支持与距离",
      "住院急诊、安全事件、体验与自付",
      "医护工时、交通和社会总成本"
    ],
    "questions": [
      "能否提高行动不便患者的连续医疗可及性？",
      "是否替代部分住院，同时保障安全和体验？",
      "支付与服务半径如何影响供给？"
    ],
    "methods": [
      "政策内容—执行过程联合分析",
      "TTE/现代DID/ITS（按数据条件）",
      "DES评估容量与排班"
    ],
    "pitfalls": [
      "把一次护理等同建床",
      "只看住院减少而忽略选择与安全",
      "将上海职工医保比例外推其他人群和地区"
    ],
    "source_ids": [
      "home20",
      "bed26",
      "primary26",
      "primary-explain",
      "bed-sh",
      "elder-hb"
    ],
    "guide": "guides/home-hospital-bed-policy-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "home-medical",
    "title": "🚪 老年人居家医疗",
    "group": "居家医疗与基层",
    "definition": "把适宜医疗服务延伸到居住场所的供给安排，可由不同服务形式实现；需区分服务内容、连续性与资格。",
    "logic": "就医障碍 → 机构供给与上门能力 → 服务触达 → 连续性与患者负担",
    "clauses": [
      "重点人群和医疗需求",
      "机构、人员、项目与安全",
      "价格、支付、信息与转诊"
    ],
    "variables": [
      "功能、居住、距离与家庭支持",
      "服务项目/频次与等待",
      "交通、自付和未满足需求"
    ],
    "questions": [
      "哪些人有需要却未获得服务？",
      "供给扩展是否改善弱势人群可及性？"
    ],
    "methods": [
      "需求—供给文本编码",
      "两部/计数模型与公平分析"
    ],
    "pitfalls": [
      "居家场所不等于居家养老",
      "“支持开展”不等于实际提供或医保报销"
    ],
    "source_ids": [
      "home20",
      "primary26",
      "bed26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "internet-nursing",
    "title": "📱 互联网+护理服务",
    "group": "居家医疗与基层",
    "definition": "依托信息平台连接申请与线下护理供给；分析平台、实体机构与护士的责任，以及安全和支付。",
    "logic": "线上申请 → 需求/风险评估 → 机构派出 → 线下护理 → 记录与反馈",
    "clauses": [
      "平台与机构责任",
      "项目准入、人员资质、知情同意",
      "安全、隐私、纠纷与支付"
    ],
    "variables": [
      "平台上线、服务地区/项目",
      "订单、完成、取消、时间与严重错误",
      "数字使用能力、价格与需求"
    ],
    "questions": [
      "数字渠道能否帮助高需求者，也可能排除哪些人？"
    ],
    "methods": [
      "条款关系抽取",
      "实施/公平评价",
      "平台分期实施的政策设计"
    ],
    "pitfalls": [
      "把平台注册量当完成服务量",
      "把服务价格存在等同已获医保支付"
    ],
    "source_ids": [
      "nurse19",
      "nurse20",
      "home20"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "family-doctor",
    "title": "🩺 家庭医生签约服务",
    "group": "居家医疗与基层",
    "definition": "长期服务关系与履约机制，评价应从签约数量走到实际服务、连续性和居民感受。",
    "logic": "签约关系 → 有效履约 → 全专/医防衔接 → 连续管理与服务感受",
    "clauses": [
      "主体、团队与协议周期",
      "服务包与履约、转诊和信息",
      "激励、费用与质量",
      "2025—2027感受度举措"
    ],
    "variables": [
      "签约、履约、接触频次与连续性",
      "慢病过程指标与患者体验",
      "团队负荷、支付与激励"
    ],
    "questions": [
      "签约覆盖扩大是否转成实际履约？",
      "哪些服务安排改善感受与连续性？"
    ],
    "methods": [
      "过程评价与混合方法",
      "多层模型/合适的政策因果设计"
    ],
    "pitfalls": [
      "签约率等同履约率",
      "用满意度替代临床或公平结局"
    ],
    "source_ids": [
      "fd22",
      "fd25",
      "bed26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "medical-elderly",
    "title": "🌿 医养结合",
    "group": "长期照护与养老",
    "definition": "组织和服务层面的医疗与养老衔接，需要把机构资质、服务过程和支付体系分开梳理。",
    "logic": "资源与资质 → 转诊和连续照护 → 医疗/生活支持整合 → 服务质量与负担",
    "clauses": [
      "机构与岗位管理",
      "医疗质量与养老服务衔接",
      "感染、安全、信息和支付责任"
    ],
    "variables": [
      "医养配置与实际协作",
      "转诊与照护断点",
      "老人功能、家庭负担与机构成本"
    ],
    "questions": [
      "机构挂牌是否伴随真实连续照护？"
    ],
    "methods": [
      "机构文本与访谈",
      "联合展示与多层评价"
    ],
    "pitfalls": [
      "挂牌等于整合有效",
      "将养老费用全部视为医疗支付范围"
    ],
    "source_ids": [
      "medelder20",
      "elder-hb",
      "ltc26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "hospice",
    "title": "🕯️ 安宁疗护",
    "group": "长期照护与养老",
    "definition": "围绕患者与家属需求的照护服务，政策研究关注服务可及、组织、质量与支付；2025实践指南应与2017历史版本区分。",
    "logic": "需求识别 → 沟通与服务衔接 → 团队照护 → 舒适、体验与家属支持",
    "clauses": [
      "对象与团队",
      "服务规范和转诊",
      "机构/居家衔接、质量与支付"
    ],
    "variables": [
      "服务可得、使用与等待",
      "患者/家属体验与目标一致性",
      "照护负担与费用"
    ],
    "questions": [
      "供给增加是否改善适宜服务的可及性？"
    ],
    "methods": [
      "政策过程/实施研究",
      "患者与家属混合方法"
    ],
    "pitfalls": [
      "把服务目标简化为缩短住院或节省费用",
      "使用旧指南却标为最新版"
    ],
    "source_ids": [
      "hospice25",
      "bed26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "drg",
    "title": "🧾 DRG按病组付费",
    "group": "医保支付与保障",
    "definition": "按疾病诊断相关分组组织医保支付的安排。分组方案、支付标准、预算、实际结算与例外机制需要分别提取。",
    "logic": "预算与分组 → 支付激励 → 医院行为 → 费用/质量/患者选择",
    "clauses": [
      "版本与分组",
      "预算、权重与点值/费率",
      "特例单议、清算与质量约束"
    ],
    "variables": [
      "首次实际结算和版本切换",
      "病例组合、编码与严重度",
      "费用、自付、住院日、再入院与质量"
    ],
    "questions": [
      "控费是否伴随质量或患者选择变化？"
    ],
    "methods": [
      "交错DID/事件研究",
      "病例组合调整和异质性"
    ],
    "pitfalls": [
      "分组升级等同首次改革",
      "只看均次费用而忽略编码与病例结构"
    ],
    "source_ids": [
      "drg24"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "dip",
    "title": "🔢 DIP按病种分值付费",
    "group": "医保支付与保障",
    "definition": "在预算与病种分值等规则下进行医保支付；需区分病种库、分值、点值形成和机构结算。",
    "logic": "区域预算 → 病种分值/点值 → 机构策略 → 资源与质量结果",
    "clauses": [
      "病种库版本",
      "预算、分值、点值与调整",
      "结算、清算、例外与监管"
    ],
    "variables": [
      "统筹区实际运行日期与规则",
      "病例组合、编码、机构负荷",
      "费用转移、质量与效率"
    ],
    "questions": [
      "预算约束如何影响机构间竞争和服务组合？"
    ],
    "methods": [
      "政策条款比较",
      "现代DID/面板与机制研究"
    ],
    "pitfalls": [
      "将名义点值当全年最终结算点值",
      "混用医院和统筹区赋值层级"
    ],
    "source_ids": [
      "drg24"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "outpatient",
    "title": "💊 门诊共济保障",
    "group": "医保支付与保障",
    "definition": "职工医保门诊保障与个人账户调整等配套改革；应把待遇变化、账户变化和基层支付激励分别测量。",
    "logic": "门诊待遇/账户调整 → 就医与购药激励 → 门住院利用 → 负担与公平",
    "clauses": [
      "门诊统筹、起付、比例、限额",
      "个人账户与家庭共济",
      "基层、药店与支付配套"
    ],
    "variables": [
      "地区/人群生效日期与待遇变化",
      "门诊药店住院利用与自付",
      "年龄、退休和医保身份"
    ],
    "questions": [
      "门诊保障扩展是否改变住院替代与费用负担？"
    ],
    "methods": [
      "交错DID/DDD（需相应假设）",
      "两部费用与分布分析"
    ],
    "pitfalls": [
      "家庭账户共济等于统筹待遇提高",
      "不区分退休与在职待遇或过渡"
    ],
    "source_ids": [
      "outpatient21",
      "primary26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "medical-aid",
    "title": "🛟 重特大疾病医疗保险与救助",
    "group": "医保支付与保障",
    "definition": "基本医保、大病保险与医疗救助的衔接安排，关注经济困难群体的托底与因病致贫风险。",
    "logic": "身份认定 → 多层保障衔接 → 实际自付 → 灾难性支出与福利",
    "clauses": [
      "对象认定与主动发现",
      "支付顺序、范围与救助",
      "申请、结算与动态监测"
    ],
    "variables": [
      "救助资格、实际获得与时间",
      "总费用、报销后自付、家庭资源",
      "灾难性卫生支出阈值/分母"
    ],
    "questions": [
      "获得保障者是否仍存在未满足医疗需求？"
    ],
    "methods": [
      "保障链条文本分析",
      "公平/财务保护与因果设计"
    ],
    "pitfalls": [
      "把大病保险和医疗救助当同一制度",
      "灾难性支出分母前后不一致"
    ],
    "source_ids": [
      "aid21"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "county",
    "title": "🔗 紧密型县域医共体",
    "group": "组织整合与治理",
    "definition": "县乡村医疗卫生体系的整合安排，重点看管理、资源、服务、医防和激励是否形成实际协同。",
    "logic": "治理与资源整合 → 基层承接与连续服务 → 分级诊疗 → 县域健康与效率",
    "clauses": [
      "人财物与决策权",
      "共享中心、转诊与信息",
      "医防融合、医保支付与绩效"
    ],
    "variables": [
      "正式组建、运行与各模块启动",
      "资源下沉、转诊和基层利用",
      "服务质量、连续性与费用"
    ],
    "questions": [
      "组织整合的哪些环节真正转化为协同？"
    ],
    "methods": [
      "制度文本+扎根/访谈",
      "DID/SDID（按处理与供体条件）"
    ],
    "pitfalls": [
      "挂名成立即完成紧密整合",
      "把同期DRG/DIP和基层供给变化忽略"
    ],
    "source_ids": [
      "county23",
      "primary26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "city",
    "title": "🏙️ 紧密型城市医疗集团",
    "group": "组织整合与治理",
    "definition": "城市网格内组织与服务协作的政策安排；试点列名、集团组建与真实运转应分别记时。",
    "logic": "网格与牵头机制 → 资源/信息共享 → 预防诊疗康复衔接 → 人群服务结果",
    "clauses": [
      "网格、牵头与成员",
      "权责、资源与绩效",
      "服务连续性、医防融合和评价"
    ],
    "variables": [
      "试点、组建、运行与覆盖范围",
      "成员关系、流程与转诊",
      "网格服务人群、利用与质量"
    ],
    "questions": [
      "网格化治理能否缩短跨机构服务断点？"
    ],
    "methods": [
      "政策关系编码",
      "多城市政策设计与实施研究"
    ],
    "pitfalls": [
      "试点名单日期等于实际服务日",
      "与县域医共体直接混成同一处理"
    ],
    "source_ids": [
      "city23",
      "city-list"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  },
  {
    "id": "tiered",
    "title": "🪜 分级诊疗与双向转诊",
    "group": "组织整合与治理",
    "definition": "通过能力、分工与激励形成合适就医秩序；基层首诊、转诊与慢病连续管理需拆开测量。",
    "logic": "基层能力与激励 → 就医选择/转诊 → 连续性与适宜服务 → 可及与效率",
    "clauses": [
      "机构功能与能力",
      "首诊、转诊、急慢分治",
      "医保、家医和信息配套"
    ],
    "variables": [
      "真实政策与服务启动",
      "基层利用、转诊方向与完成",
      "可避免住院、连续性和患者负担"
    ],
    "questions": [
      "提高基层利用是否同时改善适宜性与连续性？"
    ],
    "methods": [
      "政策工具与机制分析",
      "患者流向/多层/政策评价"
    ],
    "pitfalls": [
      "基层比例上升自动等于健康改善",
      "只记录转出不记录接收完成"
    ],
    "source_ids": [
      "tier15",
      "county23",
      "fd22",
      "primary26"
    ],
    "guide": "guides/policy-text-analysis-skill.html",
    "checked": "2026-10-23",
    "note": "条款维度、研究字段与研究问题是分析建议；政策事实以所列国家/地方原文为依据。"
  }
]