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引用本文:李萌, 郭淑岩, 张旭东, 黎浩, 陈岩, 胡广宇, 董四平.中国公立医院内部管理水平的初步测量——基于《中国医院管理调查表-扩展版》(D-CHMS)现场访谈法[J].中国卫生政策研究,2019,12(12):35-42
中国公立医院内部管理水平的初步测量——基于《中国医院管理调查表-扩展版》(D-CHMS)现场访谈法
投稿时间:2019-10-20  修订日期:2019-12-05  PDF全文浏览  HTML全文浏览
李萌1, 郭淑岩1, 张旭东1, 黎浩2, 陈岩2, 胡广宇3, 董四平1
1. 国家卫生健康委医院管理研究所 北京 100044;
2. 武汉大学全球健康研究中心 湖北武汉 430072;
3. 中国医学科学院卫生政策与管理研究中心 北京 100020
摘要:目的:分析《世界医院管理调查表扩展版(D-WMS-H)》在我国公立医院开展应用的适用性,初步测量医院内部管理水平。方法:翻译、修订D-WMS-H调查表形成《中国医院管理调查表-扩展版》(D-CHMS),通过现场访谈定量测量63家样本医院管理水平,检验D-CHMS信度和效度。结果:D-CHMS的Cronbach's alpha系数为0.911,因子分析提取5个公因子,累积方差贡献率66.986%;样本医院管理水平均分为2.97分,三甲医院和二甲医院分别为3.09分和2.82分。结论:D-CHMS具有较好信度和效度,适用于测量中国医院内部管理水平;宜采取现场访谈方法开展医院管理水平调查,不推荐使用电话访谈等非现场方法;我国三甲医院总体上建立了正式的、良好的主动管理,但二甲医院总体上还存在非正式的被动式管理;我国公立医院整体管理水平与世界主要发达国家尚存在一定差距,具备较大提升空间。
关键词:世界管理调查  医院管理实践  公立医院  信度  效度
基金项目:国家自然科学基金面上项目(71573061)
A preliminary measure of management practice in Chinese public hospitals based on Development Chinese Hospital Management Survey (D-CHMS) by on-site interview
LI Meng1, GUO Shu-yan1, ZHANG Xu-dong1, LI Hao2, CHEN Yan2, HU Guang-yu3, DONG Si-ping1
1. National Institute of Hospital Administration, NHC, Beijing 100044, China;
2. Global Health Institute, Wuhan University, Wuhan Hubei 430072, China;
3. Center for Health Policy and Management, Chinese Academy of Medical Sciences, Beijing 100020, China
Abstract:Objective:To verify the applicability of Development World Management Survey-Hospital Version (D-WMS-H) in public hospitals in China and conduct preliminary measurement of the managerial practices therein. Methods:The Development Chinese Hospital Management Survey (D-CHMS) was developed from D-WMS-H and was applied to measure the management level of 63 sample hospitals by on-site interviews. The reliability and validity of D-CHMS were also tested. Results:The Cronbach's alpha coefficient of D-CHMS was 0.911 after the measurement. From the analysis of the survey results, 5 public factors were extracted and the cumulative variance contribution rate reached 66.986% in Factor Analysis. The average management score of Samples was 2.97, in which tertiary hospitals and secondary hospitals were 3.09 and 2.82, respectively. Conclusions:Firstly, D-CHMS is suitable for measuring the internal management level of public hospitals in China for its good reliability and validity. Secondly, it is recommended to conduct on-site interview for an accurate investigation of the hospitals' management level rather than using off-site methods such as telephone or online interviews. Last but not least, China's tertiary hospitals have established formal and good active management systems, which is different from secondary hospitals because the case there is informal and passive. There is still a gap of hospital management practice between China and the many developed countries around the globe, and this gap need to be bridged through improvements and reforms, especially in secondary hospitals in China.
Key words:World management survey  Hospital management practice  Public hospital  Reliability  Validity
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