基于扎根理论的防御性医疗影响因素及作用机制分析  

Analysis of Influencing Factors and Mechanism Model of Defensive Medicine based on Grounded Theory

作　　者：尹新乐 张环宇 赵娟 王晨 冯亚杰 刘欣儒 周玥 梁立波[1] Yin Xinle;Zhang Huanyu;Zhao Juan;Liang Libo(School of Health Management,Harbin Medical University,Harbin,Heilongjiang,150081,China;不详)

机构地区：[1]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150081 [2]陆军军医大学第一附属医院,重庆400038 [3]重庆市妇幼保健院,重庆401147

出　　处：《中国医院管理》2024年第7期6-10,15,共6页Chinese Hospital Management

基　　金：国家自然科学基金项目(71974049,71673073,72274047)。

摘　　要：目的明确防御性医疗的影响因素,为防范和化解防御性医疗提供思路。方法检索防御性医疗相关文献,访谈防御性医疗的相关人员,运用扎根理论方法对文献资料和访谈资料进行编码,归纳相关概念和范畴。结果经过三级编码,梳理出52个初始概念、23个初始范畴、7个副范畴和3个主范畴,分析影响因素之间的关联,构建防御性医疗“医患关系—制度体系—社会环境”三维影响因素及作用机制模型。结论防御性医疗的影响因素主要包括医患关系、制度体系、社会环境3大方面,三者通过不同作用机制对防御性医疗产生影响,为防御性医疗相关研究提供了因素之间综合分析的定性证据。Objective To clarify the influencing factors of defensive medicine and provide ideas for preventing and resolving defensive medicine.Methods Literature related to defensive medicine was searched,personnel related to defensive medicine were interviewed,and literature and interview data were coded with the method of grounded theory,and related concepts and categories were summarized.Results After three levels of coding,52 initial concepts,23 initial categories,7 sub-categories and 3 main categories were sorted out,and the correlation among influencing factors was analyzed to build a three-dimensional model of“doctor-patient relationship-institutional system-social environment”influencing factors and their mechanism of action.Conclusion The influencing factors of defensive medicine mainly include doctor-patient relationship,institutional system and social environment.The three factors have an impact on defensive medicine through different mechanisms of action,which provides qualitative evidence for comprehensive analysis of factors in related studies of defensive medicine.

关 键 词：扎根理论 防御性医疗 影响因素 作用机制 

分 类 号：R197.3[医药卫生—卫生事业管理]