| 引用本文：王曼丽, 方海清, 夏述旭, 施楠, 高兴民, 陶红兵.基于扎根理论的纵向紧密型医疗联合体绩效形成机制理论框架构建[J].中国卫生政策研究,2019,12(8):1-9 |
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| 基于扎根理论的纵向紧密型医疗联合体绩效形成机制理论框架构建 |
| 投稿时间：2019-02-16 修订日期：2019-06-25 PDF全文浏览 HTML全文浏览 |
| 王曼丽1, 方海清2, 夏述旭3, 施楠3, 高兴民1, 陶红兵3 |
1. 深圳大学中国经济特区研究中心 广东深圳 518060;
2. 深圳市人民医院 广东深圳 518020;
3. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030 |
| 摘要:目的：探讨纵向紧密型医疗联合体绩效形成机制，发现影响绩效形成的问题并提出相应对策。方法：按照目的、理论和滚雪球抽样结合扎根理论研究方法对10家典型纵向紧密型医疗联合体的43名管理实践者进行半结构化访谈，经开放式编码、主轴编码、选择性译码构建纵向紧密型医疗联合体绩效形成机制理论框架。结果：梳理绩效形成机制的4类关系：前提条件、行动策略、维持条件、绩效。结论：在政策层面加强对医务人员和居民的宣传；医疗联合体内部应该明确职责分工，健全分级诊疗标准，完善下派专家激励机制，提倡药物和处方延伸；加强信息化建设；政府应该做好医保支付方式改革，完善配套政策措施建设，加强对医疗联合体的绩效考核。 |
| 关键词:纵向紧密型医疗联合体 绩效形成机制 扎根理论 |
| 基金项目:国家自然科学基金面上项目（71473099）；教育部人文社科重点研究基地重大项目（16JJD790041） |
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| The construction of a theoretical framework of the performance formation mechanism of vertical and compact medical consortium based on Grounded Theory |
| WANG Man-li1, FANG Hai-qing2, XIA Su-xu3, SHI Nan3, GAO Xing-min1, TAO Hong-bing3 |
1. China Center for Special Economic Zone Research, Shenzhen University, Shenzhen Guangdong 518060, China;
2. Shenzhen People's Hospital, Shenzhen Guangdong 518020, China;
3. School of Meicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan Hubei 430030, China |
| Abstract:Objective:To explore the performance formation mechanism of the vertical and compact medical consortium in order to build a string theoretical framework, to find out the problems influencing the performance, and finally propose corresponding strategies and countermeasures. Methods:A total of 43 managers from 10 typical vertical and compact medical consortiums were selected with objective, theoretical and snowball sampling methods, then they were interviewed according to the Grounded Theory. Thereinafter, the interview records were analyzed with open coding, axial or spindle coding and selective coding and used to construct the vertical and compact theoretical framework for medical associations. Results:Four lines of the performance formation mechanism were sorted out including the premise condition, action strategy, maintaining conditions and performance context. Conclusions:The government should strengthen the publicity of medical staff and residents at policy level to enhance their belonging sense; the division of duties and responsibilities should be clearly defined within medical consortiums, the graded diagnosis standard should be improved, the incentive mechanism should be perfected for the dispatching experts, the extension of prescription and drugs should be advocated, and the construction of an effective information technology system should be strengthened. It is also recommended that the government should do a reform in healthcare payment methods, improve the establishment of supporting policies and measures, and strengthen the performance appraisal of the medical consortiums. |
| Key words:The vertical and compact medical consortium Performance formation mechanism Grounded Theory |
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