摘要
目的:定量分析县域医共体各级医疗机构的协作程度,探索提高协作水平的策略建议。方法:基于D’ Amour组织协作模型,结合五点式评分法,自制调查问卷收集资料,以广东省为例,分析县域医共体“县-乡-村”三级医疗机构的协作程度。结果:当前县域医共体三级医疗机构之间的协作水平属于积极型协作,整体得分为47.14±12.36分(得分率78.57%),但整体上仍未形成有效的利益共享机制(3.61±1.37分,得分率72.20%),以及机构成员之间缺乏有效的沟通交流机制而难以提高相互熟悉程度(3.78±1.14分,得分率75.60%)。不同单位类型对协作水平的评价不同,牵头县医院的评分最高(48.69±10.58分),乡镇卫生院最低(44.76±12.91分)(P<0.001)。结论:县域医共体下一步建设应以构建利益共享机制、提升各级医疗机构医务人员之间的内在认同为主,同时要重视乡镇卫生院的发展需求和医疗服务能力提升。
Objective To quantitatively analyze the cooperation degree of medical institutions at all levels of county health serv-ice communities,and explore the strategies and suggestions to improve the cooperation level.Methods Based on the D'Amour organi-zation and cooperation model,combined the five-point scoring method,and sampled with Guangdong Province,data were collected by using self-made questionnaire to analyze the cooperation degree of the three-level"county-township-village"medical institu-tions in the county health service communities.Results The level of collaboration among the tertiary healthcare institutions in the county-level medical consortium was classified as active collaboration,the overall score of which was 47.14±12.36,with a score rate of 78.57%.However,the effective mechanism for sharing benefits had not been established,the score of which was 3.61±1.37,with a score rate of 72.20%.Additionally,there was a lack of effective communication mechanism among the members of the organi-zations,leading to difficulties in improving the mutual familiarity,the score of which was 3.78±1.14,with a score rate of 75.60%.There were different evaluations of the collaboration level in different types of institutions,in which the leading county hospital re-ceived the highest score of(48.69±10.58),while township health centers received the lowest score of(44.76±12.91)(P<0.001).Conclusion The next step in the construction of the county-level medical community is to build a benefit-sharing mecha-nism and enhance the internal identity among medical staffs in medical institutions at all levels.At the same time,it is also important to pay attention to the development needs of township hospitals and the improvement of medical service capabilities.
作者
蔡秋茂
柯夏童
杜芳
曾华堂
朱宏
Cai Qiumao(School of Public Health,Southern Medical University,Guangzhou,P.R.China)
出处
《中国卫生事业管理》
北大核心
2023年第9期641-646,687,共7页
Chinese Health Service Management
基金
国家重点研发计划项目“健康管理综合服务应用示范”(2020YFC2006400)
广东省医学科研基金“多元协同治理视角下分级诊疗的实现路径研究和效果评价”(C2022119)。
关键词
县域医共体
三级医疗机构
协作程度
D'Amour模型
county health service communities
tertiary medical institutions
cooperation degree
D'Amour model
