医疗联合体经济激励协同改革对医生协调性医疗服务行为的影响研究  

Research on the Influence of Economic Incentive Cooperative Reform of Medical Alliance on Doctors’Coordinated Medical Service Behavior

作　　者：周津 李璐[2] 钟正东 林坤河[1] 刘宵 吴文琪 熊英贝 项莉[1] Zhou Jin;Li Lu;Zhong Zhengdong(School of Medicine and Health Management,Tongji Medical College,Huazhong Univer-sity of Science and Technology,Wuhan,Hubei,430030,China;不详)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430000 [2]广州医科大学卫生管理学院,广东广州511436

出　　处：《中国医院管理》2023年第10期26-30,共5页Chinese Hospital Management

基　　金：国家自然科学基金项目(71874058,72174068);广东省医学科学技术研究基金项目(C2021071)。

摘　　要：目的探讨内外部经济激励协同改革对医疗联合体内医生协调性医疗服务行为的影响,为改善医生转诊及下沉基层服务行为提供参考建议。方法采用问卷调查法对深圳市龙华区医疗联合体内2个区级牵头医院的临床医生进行调查,利用主成分分析及二元logistic回归分析探寻医生协调性医疗服务行为的影响因素。结果实际共回收有效问卷254份,改革后,68.1%的医生增加了转诊服务,59.5%的医生增加了下沉基层服务,经济收益因子(F1)及工作环境因子(F2)与医生协调性医疗服务行为正相关(P<0.05)。结论内外部经济激励措施通过改变医生的经济收益及工作环境的分工协作程度,可以提高医生协调性医疗服务的供给。发挥内外部经济激励制度的协同作用,提高经济收益、改善工作环境以促进医生提供协调性医疗服务。Objective To explore the influence of internal and external economic incentive coordination reform on co⁃ordinated medical service behavior of doctors in medical alliance,and to provide reference suggestions for improving doctors’referral and subdivision service behavior.Methods A questionnaire survey was conducted among clinicians in two leading hospitals of in Longhua District medical alliance Shenzhen.Principal component analysis and binary logis⁃tic regression were used to examine the related factors affecting doctors’coordinated medical service behavior.Results A total of 254 valid questionnaires were collected.After the reform,68.1%of doctors increased the referral service,59.5%of doctors increased the output service.Economic income factor(F1)and working environment fac⁃tor(F2)had a positive correlation with doctors’coordinated medical service behavior(P<0.05).Conclusion Inter⁃nal and external economic incentives can improve the supply of coordinated medical services by changing the eco⁃nomic benefits of doctors and the degree of division of labor and cooperation in the working environment.Bring into play the synergistic effect of internal and external economic incentive system to improve economic returns and working environment to promote doctors to provide coordinated medical service.

关 键 词：医疗联合体 经济激励 协调性 医疗服务行为 

分 类 号：R197.3[医药卫生—卫生事业管理]