基于定性比较分析的公立医院公益性作用路径研究  

Research on the pathways of social responsibility of public hospitals based on qualitative comparative analysis

作　　者：邓清文 魏艳[1] 刘世蒙 陈英耀[1] Deng Qingwen;Wei Yan;Liu Shimeng;Chen Yingyao(School of Public Health,Fudan University/Key Lab of Health Technology Assessment,National Health Commission,Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032

出　　处：《中华医院管理杂志》2023年第4期288-292,共5页Chinese Journal of Hospital Administration

摘　　要：目的探讨公立医院公益性的影响要素与作用路径,为我国公立医院进一步提升公益性水平提供路径参考。方法于2019至2020年,选取某地区22家三级公立医院作为研究案例,以公益性得分为结果变量,以社会效益、适宜性、质量和效率为条件变量,运用定性比较分析方法探究影响公立医院公益性的条件组合。结果社会效益、适宜性和质量的一致性均小于0.9、大于0.8,提示其为公立医院高公益性的充分非必要条件;效率的一致性为0.747,提示其非充分也非必要条件。组态分析结果显示,公立医院实现高公益性的条件组合包括高质量助力下的社会效益与适宜性驱动型,高质量助力下的社会效益与效率驱动型,以及适宜性与效率驱动型3种,覆盖率为92.6%。结论社会效益、适宜性、质量和效率能够以不同组合路径实现公立医院高公益性。公立医院可根据实际情况制定针对性的公益性提升策略,加强各要素之间的协同匹配。Objective To explore the influencing factors and pathways of social responsibility of public hospitals,and to provide a reference for public hospitals in China to further improve the social responsibility level.Methods From 2019 to 2020,22 tertiary public hospitals in a region were selected as study cases.The social responsibility score was used as the outcome variable,social benefit,appropriateness,quality,and efficiency were used as the conditional variables,and the qualitative comparative analysis was applied to investigate the combination of conditions affecting social responsibility evaluation of public hospitals.Results The consistency of the social benefit,appropriateness,and quality was less than 0.9 and greater than 0.8,indicating that they were sufficient and non-necessary conditions for high social responsibility of public hospitals.The consistency of efficiency was 0.747,indicating that it was neither sufficient nor necessary condition.The configuration analysis showed that there were three paths for public hospitals to achieve high social responsibility:co-driven social benefit and appropriateness with high quality assistance,co-driven social benefit and efficiency with high quality assistance,and co-driven appropriateness and efficiency,with a coverage rate of 92.6%.Conclusions Social benefit,appropriateness,quality,and efficiency can be combined in different ways to achieve high social responsibility in public hospitals.Public hospitals could develop targeted social responsibility improvement strategies according to the actual situation,and strengthen the synergy between the elements to improve the level of social responsibility in hospitals.

关 键 词：医院 公立 公益性 定性比较分析 影响因素 作用路径 

分 类 号：R197.3[医药卫生—卫生事业管理]