县域远程心电急救网络构建与机制分析——以H省S县为例

Construction and Mechanism of County-Level Telecardiology Emergency Network—A Case Study of County S, Province H

摘要: 目的：探讨远程医疗技术在基层公共卫生事件中预警与应急响应的模式构建，为基层心梗急救体系建设提供参考。方法：以H省S县“心电一张网”项目为案例，采用单案例深度剖析方法，结合参与式观察和档案资料整理分析，运用协同治理理论和网络治理理论作为分析框架，系统还原S县心电急救网络的建构过程与运作逻辑。结果：截至2025年10月，累计上传心电图9.65万份，高危急性心肌梗死患者死亡率从10.46%降至1.46%，门-球时间(D2B)时间缩短至70分钟以内。结论：该案例以卫生行政部门为核心枢纽，通过资源动员、规则设计和关系协调，打破了多部门协调困境，建立了激励相容机制。数字化与区域协同体系结合的模式有效弥补了偏远山区基层急救能力的不足，政府驱动的协同治理机制具有较强的可复制性，为我国中西部欠发达县域基层急救体系建设提供了可参考的实践样本。

Abstract: Objective: This paper aims to construct an early warning and emergency response model of telemedicine for grassroots public health emergencies, and offer implications for grassroots myocardial infarction emergency systems. Methods: Based on “The ECG Network” project in County S, Province H, this paper conducts in-depth single-case analysis via participatory observation and archival research. Applying collaborative and network governance theories, it systematically sorts out the construction and operational logic of the local ECG emergency network. Results: By October 2025, over 90,000 ECGs were uploaded in total. The mortality of high-risk AMI patients decreased from 10.46% to 1.46%, with D2B time controlled within 70 minutes. Conclusions: Centered on health administrative department, the model resolves cross-departmental coordination barriers via resource mobilization, rule design and relationship coordination, forming an incentive-compatible mechanism. The combination of digital tools and regional collaboration fills the gap of grassroots emergency services in remote mountain regions. The government-led collaborative governance model is highly replicable and offers practical experience for developing grassroots emergency systems in less-developed counties across central and western China.