| 引用本文：张静, 王虎峰, 崔兆涵.衡量县级公立医院变革力的新视角：基于力场模型的指标评价[J].中国卫生政策研究,2019,12(4):20-26 |
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| 衡量县级公立医院变革力的新视角：基于力场模型的指标评价 |
| 投稿时间：2019-01-02 修订日期：2019-04-01 PDF全文浏览 HTML全文浏览 |
| 张静1,2, 王虎峰2,3, 崔兆涵3 |
1. 国家神经系统疾病临床医学研究中心(首都医科大学附属北京天坛医院) 北京 100070;
2. 中国人民大学医改研究中心 北京 100872;
3. 中国人民大学公共管理学院 北京 100872 |
| 摘要:目的：本研究引入卢因组织变革理论的力场模型，针对“县政府、县政府医改相关职能部门、县级公立医院”这一组织单元构建综合指标体系进行变革力评价。方法：综合应用半结构访谈、德尔菲法、文本分析、锚定分级、配对分析、文献研究等方法进行评价体系开发、指标体系无量纲化处理、评价指标体系案例验证和评价体系的三角互证。结果：构建了反映我国县级公立医院综合改革变革力的综合评价指标体系，由驱动力和制约力双向指标体系组成，共包含指标84项，可以量化得出改革的驱动力和制约力，以及力场变化趋势；并采用三角互证法对指标体系的效度进行了检验。结论：指标体系的评价视角与评价方式具有创新性，可用于我国县级公立医院综合改革过程中的评价，深入直观地解释改革的经验和遇到的问题以及改革发展不平衡的原因，同时对城市公立医院综合改革的评价具有较强的借鉴意义。 |
| 关键词:公立医院综合改革 卢因力场模型 变革力 指标体系 评价 |
| 基金项目:中国人民大学科学研究基金（中央高校基本科研业务费专项资金资助）（16XNL003） |
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| A new perspective to measure the transformational power of county-level public hospitals:A study based on the force-field model indicators |
| ZHANG Jing1,2, WANG Hu-feng2,3, CUI Zhao-han3 |
1. China National Clinical Research Center for Neurological Diseases(Beijing Tiantan Hospital, Capital Medical University), Beijing 100070, China;
2. Health Reform and Development Center of Renmin University of China, Beijing 100872, China;
3. School of Public Administration and Policy, Renmin University of China, Beijing 100872, China |
| Abstract:Objective:This study introduces the Lewin's force-field analysis change theory model and constructs a comprehensive indicator system for conducting the evaluation of change in the organizational unit consisting of "county government, county government medical reform departments, county-level public hospitals". Methods:Semi-structure interview, Delphi method, content analysis, anchored rating scale, matching analysis, literature research and other methods are used practically and theoretically in developing the evaluation system, quantifying the indicator system, and validating the evaluation indicator system. Results:In this paper, a comprehensive evaluation indicator system that reflects the transformational power of county hospital comprehensive reform in China is constructed. It consists of a set of two opposite forces, namely driving forces and restraining forces, and the power of change can be quantified by the embedded 84 indicators. A case study and triangulation are deployed to validate and test the robustness of the comprehensive indicator system. Conclusion:The evaluation perspective and evaluation method of the indicator system are innovative and can be used in the evaluation process of the comprehensive reform of county-level public hospitals in China. The experiences and challenges encountered in the reform and the reasons for the imbalance of reform and development are explained in depth and intuitively. The evaluation of comprehensive reform of urban public hospitals has a strong significance for reference. |
| Key words:Comprehensive reform of public hospitals Lewin's force-field model Transformational power Indicator system Evaluation |
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