| 引用本文：刘小君, 刘智勇, 张丽芳, 姚强.基于共生理论的城市医联体绩效的影响因素及路径分析[J].中国卫生政策研究,2023,16(5):8-14 |
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| 基于共生理论的城市医联体绩效的影响因素及路径分析 |
| 投稿时间：2023-02-02 修订日期：2023-04-12 PDF全文浏览 HTML全文浏览 |
| 刘小君1, 刘智勇1, 张丽芳2, 姚强3 |
1. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
2. 国家卫生健康委卫生发展研究中心 北京 100044;
3. 武汉大学政治与公共管理学院 湖北武汉 430072 |
| 摘要:目的：探索城市医联体绩效实现高水平的影响因素和路径，为我国城市医联体绩效管理提供参考依据。方法：基于共生理论的基本要素构建城市医联体影响因素框架，利用25个城市医联体典型案例，通过清晰集定性比较方法，分析影响城市医联体绩效的关键因素和路径。结果：协作制度、机构间资源互补度、业务关联度、经济关联度、考核激励、政府支持和信息平台均是影响城市医联体绩效的前因条件，并形成了业务融合型、管理融合型、组织合并型3种高水平绩效的城市医联体类型。结论：城市医联体应坚持医保医疗改革协同发展，以学科和健康服务为触点，以资源协同治理为核心，加强信息化建设，完善政府正向考核激励，提高城市医联体建设水平，促进城市医联体成为四个共同体。 |
| 关键词:医疗联合体 绩效管理 定性比较分析 共生理论 分级诊疗 |
| 基金项目:国家自然科学基金面上项目(71874059) |
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| Analysis of influencing factors and paths of urban medical consortium performance based on symbiosis theory |
| LIU Xiao-jun1, LIU Zhi-yong1, ZHANG Li-fang2, YAO Qiang3 |
1. School of Medicine and Health Management, Tongji Medical College of HUST, Wuhan Hubei 430030, China;
2. China National Health Development Research Center, Beijing 100044, China;
3. School of Political Science and Public Administration, Wuhan University, Wuhan Hubei 430072, China |
| Abstract:Objective: This study tries to identify influencing factors of performance of urban medical consortiumand paths for enhancing its performance, and to provide reference for management of urban medical consortiumin China.Methods: Based on the basic elements of symbiosis theory, the framework of influencing factors of urban medical alliances was constructed, and the key factors and paths affecting the performance of urban medical alliances were analyzed by using 25 typical cases of urban medical alliances through Crisp-set of qualitative comparison analysis (csQCA). Results: Performance of urban medical consortium is influenced by factors such as the collaborative system, inter-agency resource complementarity, business correlation, economic connections, assessment incentives, government support, and information platform. Three types of high-levelurban medical alliances are formed: operational integration, management integration, and organizational integration.Conclusion: Urbanmedical alliances should focus on cooperative development of medical insurance and reform, take disciplines and health services as the contact point, prioritize resource coordinated governance, improve informatization construction, promote government assessment incentives, andimprove the construction level of urban medical alliances, and promote urban medical alliances to become four communities. |
| Key words:Medical consortium Performance management Qualitative comparative analysis(QCA) Symbiotic theory Hierarchic medical system |
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