按人头总额预付下医共体内医务人员纵向协作研究  

Research on the vertical cooperation relationship of medical staff within medical alliance under the condition of capitation prepayment

作　　者：胡晓梅 黄薇 陈迎春[2,3] 谭敏 HU Xiaomei;HUANG Wei;CHEN Yingchun;TAN Min(Department of Health Policy and Hospital Management Research,Sichuan Provincial People’s Hospital,University of Electronic Science and Technology of China,Sichuan Province,610072,PRC;不详)

机构地区：[1]电子科技大学附属医院·四川省人民医院卫生政策与医院管理研究所,四川省成都市610072 [2]华中科技大学同济医学院医药卫生管理学院,湖北省武汉市430030 [3]湖北省人文社科重点研究基地-农村健康服务研究中心,湖北省武汉市430030

出　　处：《中国医院》2022年第6期6-9,共4页Chinese Hospitals

基　　金：国家自然科学基金项目“农村住院患者合理流动的最小累积阻力模型研究”(71673101);四川省科技厅软科学研究计划项目“四川省整合型医疗卫生服务体系典型案例研究”(21RKX0147)。

摘　　要：目的:探索按人头总额预付实施下医共体内部各级医务人员纵向协作关系,提出相关政策建议。方法:以云南省X县医共体内县乡医务人员为研究对象,运用PINCOM框架,分析按人头总额预付下医共体内县乡医务人员协作现状。结果:按人头总额预付下X县医共体内各级医院领导对县乡协作重视程度高、医务人员协作意愿较高以及协作相关业务规范得以建立,且乡级医务人员协作意愿显著高于县级医务人员(t=-3.079,P=0.003),但县乡医务人员存在彼此内在认同不足、缺乏有效交流机制以及协作的内在激励。结论:加强教育宣传与基层能力建设、促进内在认同、创新协作模式、建立交流机制、改革薪酬绩效制度、形成合理有效激励是促进按人头总额预付下医共体内医务人员纵向协作的关键。Objective:To explore the vertical cooperation relationship of the medical staff at all levels within the medical community under the implementation of prepayment based on total headcount,and to put forward relevant policy suggestions.Methods:Taking the medical staff in the county and township of the medical community in X County,Yunnan Province as the research object,using the PINCOM framework,the current situation of the medical staff cooperation in the medical community in the medical community under the prepayment of total headcount was analyzed.Results:The leaders of hospitals at all levels in the medical community in X county paid high attention to county-township cooperation,the medical staff’s willingness to cooperate was high,the cooperation-related business norms were established,and the town-level medical staff’s willingness to cooperate was significantly higher than that of the county-level.medical staff (t=-3.079,P=0.003),but the county and township medical staff had insufficient mutual recognition,lack of effective communication mechanism,and intrinsic incentive for collaboration.Conclusion:Strengthening education and publicity and capacity building at the grassroots level,promoting internal recognition,innovating cooperation models,establishing communication mechanisms,reforming salary and performance systems,and forming reasonable and effective incentives are the keys to promoting the vertical cooperation of medical staff in the medical community under the prepayment of total headcount.

关 键 词：PINCOM模型 按人头总额预付 医共体 医务人员 纵向协作 

分 类 号：R197[医药卫生—卫生事业管理]