卫生管理者视角下政策与管理制度因素对医疗机构间组织协作的影响研究  

Research on the Influence of Policy and Management System Factors on Organizational Collaboration among Medical Institutions at Different Levels:Based on the Perspective of Health Managers

作　　者：潘文文 程港镁 王小合[1] 钱宇[2] 陈洁[3] 彭志毅 陈小雨 王雨清 Pan Wenwen;Cheng Gangmei;Wang Xiaohe(Department of Health Management and Policy,School of PublicHealth,Hangzhou NormalUniversity,Hangzhou,Zhejiang,311121,China)

机构地区：[1]杭州师范大学公共卫生学院,浙江杭州311121 [2]杭州市第一人民医院,浙江杭州310006 [3]浙江大学医学院附属第一医院,浙江杭州310003 [4]北京中医药大学管理学院,北京100029

出　　处：《中国医院管理》2022年第9期12-17,共6页Chinese Hospital Management

基　　金：国家自然科学基金面上项目(71974050)。

摘　　要：目的基于卫生管理者视角,分析政策与管理制度因素对区域内不同层级医疗机构间组织协作程度的影响,为推进分级诊疗制度建设提供参考。方法采用多阶段抽样方法,对浙江省8地市666名卫生管理者开展问卷调查。采用t检验、方差分析、多重线性回归、结构方程模型等方法进行数据分析。结果卫生管理者对政策与管理制度因素的总体感知评价为3.60分,对区域内不同层级医疗机构间组织协作程度的总体感知评价为3.78分;政策制度(总效应0.466)、管理体制机制(总效应0.227)、资源配置(总效应0.034)、信息共享(总效应0.217)对区域内不同层级医疗机构间组织协作程度有影响。结论加强政府对基层医疗机构政策扶持力度,促进不同层级医疗机构间组织协作;借助信息化手段实现区域卫生资源共享,破解医疗机构间组织协作难题;加强医疗机构管理者政策学习研究,扎实推进分级诊疗制度建设。Objective Based on the perspective of health managers,it analyzed the influence of policy and management system factors on the degree of organizational cooperation among medical institutions at different levels in the region,and provided a reference for promoting the construction of a hierarchical diagnosis system.Methods A multi-stage sampling method was used to conduct a questionnaire survey among 666 health managers in 8 cities of Zhejiang Province.Data analysis was performed based on t-test,analysis of variance,multiple linear regression,and structural equation modeling.Results The overall perception evaluation of health managers on policy and management system factors was 3.60 points,and the overall perception evaluation of the degree of organizational collaboration among medical institutions at different levels in the region was 3.78 points.Policy system(total effect 0.466),management system(total effect is 0.227),resource allocation(total effect is 0.034)and information sharing(total effect is 0.217)have an impact on the degree of organizational collaboration among medical institutions at different levels in the region.Conclusion It is needed to strengthen the government’s policy support for primary medical institutions and promote organizational cooperation between medical institutions at different levels,realize regional health resource sharing using information technology,and solve the problem of organizational cooperation among medical institutions;strengthen policy study and research of medical institution managers,and solidly promote the construction on hierarchical diagnosis and treatment system.

关 键 词：政策与管理制度 卫生管理者 组织协作 

分 类 号：R197.3[医药卫生—卫生事业管理]