基于前景理论的社会办医疗机构违法行为管理策略分析  

Analysis of management strategies for illegal behaviors of private medical institutions based on prospect theory

作　　者：梁思思 刘秀玲 王颖[2] LIANG Sisi;LIU Xiuling;WANG Ying(Institute of Health Supervision,Shanghai Pudong District Health Commission,Shanghai 200129,China;Fudan University,Shanghai 200433,China)

机构地区：[1]上海市浦东新区卫生健康委员会监督所,上海200129 [2]复旦大学,上海200433

出　　处：《卫生软科学》2023年第10期48-51,共4页Soft Science of Health

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划(PWRq2020-51)。

摘　　要：[目的]了解上海市浦东新区社会办医疗机构违法行为情况,从而提出管理建议。[方法]应用前景理论,对2020年上海市浦东新区社会办医疗机构不良执业行为,从执法机构检查威慑和医疗机构管理者心理活动2个维度进行调查分析。[结果]经营亏损的医疗机构比未亏损的医疗机构更容易被记分(χ^(2)=4.473,P<0.05);20.5%的医疗机构认为卫生执法部门能查到自身违法违规行为的概率不足5%;有11.8%的不良执业行为是管理者明确为了降低确定的成本而主观选择的。[结论]医疗机构的风险行为选择具有参考点依赖、概率非线性加权、敏感性递减、损失厌恶和框架效应5个特点。卫生监管效果在一定程度上取决于执法者执法水平及医疗机构管理者对不良执业行为的风险态度,良好的营商环境、执法者高水平的执法技巧有助于降低医疗机构不良执业行为的发生率。Objective To understand illegal behaviors of private medical institutions in Pudong New Area of Shanghai,and put forward suggestions of management.Methods This paper investigated and analyzed the malpractice of private medical institutions in Pudong New Area of Shanghai in 2020 from two dimensions:deterrence of inspection of law enforcement agencies and psychological activities of medical institution managers based on prospect theory.Results Medical institutions with operating losses were more likely to be scored than those without losses(χ^(2)=4.473,P<0.05).20.5%of medical institutions believed that the probability of law enforcement agencies detecting their malpractices were less than 5%;11.8%of malpractices were subjective choices made by managers in order to reduce certain costs.Conclusions The selection of risk behaviors of medical institutions has five characteristics:reference dependence,nonlinear probability weighting,diminishing sensitivity,loss aversion and framing effect.To some extent,the effect of health supervision depends on the level of law enforcement and the risk attitude of medical institution managers towards malpractice.Good business environment and high level of law enforcement skills of law enforcement officers can help reduce the incidence of malpractices in medical institutions.

关 键 词：社会办医疗机构 前景理论 不良执业行为 卫生管理 

分 类 号：R197.3[医药卫生—卫生事业管理] R197.4[医药卫生—公共卫生与预防医学] R197.5R197.6