摘要
基于自行设计量表从上海26家参与卫生资源下沉改革医院收集440份医生有效问卷,利用结构方程模型(Structural Equation Model,SEM)实证探讨卫生资源下沉改革对医生反应的影响。研究发现,卫生资源下沉改革情境下不同等级医院医生具有差异化的改革认知和反应,一级医院医生改革认知和医疗技能提升显著高于其他等级医院。安全需求、生存需求、成长需求和改革配套政策均对医生行为反应有显著正向影响,纳入政府保护、医院保护和法律保护的安全需求的影响最大。中介效应检验发现,纳入改革认知和支持在内的改革态度对改革反应有直接效应,还正向中介了改革配套政策的间接效应。
Based on self-designed scale,440 valid questionnaires for doctors are collected from 26 hospitals participating in the reform of channeling medical resources down to the community level in Shanghai.The Structural Equation Model(SEM)is used to empirically explore the impact of the reform on the behavioral doctors’response.It is found that doctors at different levels of hospitals have different cognition and response,and doctors of first-level hospitals have significantly higher cognitive and medical skills improvement than those of other levels of hospitals.In addition,safety needs,survival needs,growth needs and supporting policies for reform all have significant positive effects on doctors’behavioral responses.To be specific,the safety needs included in protection from the government,hospital and legislation have the greatest impact.The test of mediation effect shows that attitude to the reform,including recognition on the reform and support to the reform,has a direct effect on responses to the reform,and also positively mediated indirect effect of supporting policies for the reform.
作者
张露丹
刘蕾
南德红
孙泽生
ZHANG Ludan;LIU Lei;NAN Dehong;SUN Zeshengi(School of Finance and Business,Shanghai Normal University,Shanghai 200234,China;Evaluation Office,Shanghai University of Medicine&Health Sciences,Shanghai 200237,China)
出处
《福建医科大学学报(社会科学版)》
2021年第3期11-17,71,86,共9页
Journal of Fujian Medical University:Social Science Edition
基金
2020年上海市人民政府发展研究中心决策咨询项目(2020-YJ-C05)
国家大学生创新创业训练计划项目(SXY-2020-005)。
关键词
卫生资源下沉改革
医生
改革反应
结构方程模型
reform of channeling medical resources down to the community level
doctors
response to reform
structural equation model