| 引用本文：刘羽佳, 陆方.基于互惠理论的医养结合机构合作研究[J].中国卫生政策研究,2023,16(3):54-62 |
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| 基于互惠理论的医养结合机构合作研究 |
| 投稿时间：2022-11-28 修订日期：2023-03-10 PDF全文浏览 HTML全文浏览 |
| 刘羽佳, 陆方 |
| 南京医科大学医政学院 江苏南京 211166 |
| 摘要:基于互惠理论分析框架，采用扎根研究与多案例研究方法，针对公对公、委托经营、公对私合作类型的三家案例，对合作不同阶段合作方的互惠行为及其演变过程进行探析，厘清互惠行为对合作结局的影响。研究发现，不同合作类型下，合作方所有权性质不同，做出的互惠行为调整有所差异，从而影响合作方的态度和合作结局。公对公合作中养老机构决策自主性和灵活性较低，易出现互惠强度的不对等，从而影响合作方的态度，合作易破裂；委托经营合作中民营合作方建设压力较小可以集中于机构运营，加之政府提供持续互惠，合作容易顺利推进；公对私合作中，民营养老机构自主性和灵活性较强，双方可以通过资源互补实现共赢发展。建议：对于公对公合作类型应扩大养老机构服务范围，给予更多运营自主权；对于委托经营合作类型政府应针对合作不同时期精准施策，持续助力机构发展；对于公对私合作类型政府应出台相关技术标准，使得合作双方有据可依，医养结合机构应不断拓展合作范围，实现共赢发展。 |
| 关键词:医养结合机构 互惠行为 合作 |
| 基金项目:国家自然科学基金青年基金(71804075) |
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| A study on cooperation of medical and nursing institutions based on reciprocity theory |
| LIU Yu-jia, LU Fang |
| School of Medical Administration， Nanjing Medical University， Nanjing Jiangsu 211166， China |
| Abstract:Based on the framework of reciprocity theory, this paper adopts the method of grounded research and multi-case study to analyze the reciprocity behavior of partners in different stages of cooperation and its evolution in three cases of public-to-public, entrusted management and public-to-private cooperation, so as to clarify the influence of reciprocity behavior on the outcome of cooperation. It is found that, under different types of cooperation, the ownership nature of partners is different, and the adjustment of reciprocal behavior is different, which affects the attitude of partners and ultimately leads to different outcomes of cooperation. In the public-to-public cooperation, the decision-making autonomy and flexibility of pension institutions are low, which is prone to the asymmetry of reciprocity intensity, thus affecting the partner's attitude and the cooperation is easy to break down. In entrusted business cooperation, private partners have less construction pressure and can focus on institutional operation. In addition, the government provides continuous reciprocity, so the cooperation is easy to move forward smoothly. In the public-private cooperation, private pension institutions have strong autonomy and flexibility, and both sides can achieve win-win development through resource complementarity. Suggestions: For the type of public-to-public cooperation, the service scope of elderly care institutions should be expanded and more operational autonomy should be given; For entrusted business cooperation, the government should take precise measures according to different periods of cooperation, and continue to help the development of institutions; For public-private cooperation, the government should issue relevant technical standards, so that both parties can rely on the basis of the cooperation, medical and nursing institutions should continue to expand the scope of cooperation, to achieve win-win development. |
| Key words:Medical and nursing institutions Reciprocal behavior Cooperation |
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