[1]杨 松,钟艳红,王 绪,等.DRG背景下医疗服务行为规范影响因素分析——基于结构方程模型[J].卫生经济研究,2023,40(7):50-55.
 YANG Song,ZHONG Yanhong,WANG Xu,et al.Study on the Influencing Factors of Medical Service Behavior Norms in the Context of DRG Payment ——Based on Structural Equation Model[J].Journal Press of Health Economics Research,2023,40(7):50-55.
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DRG背景下医疗服务行为规范影响因素分析——基于结构方程模型
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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
40
期数:
2023年7期
页码:
50-55
栏目:
健康服务体系
出版日期:
2023-06-30

文章信息/Info

Title:
Study on the Influencing Factors of Medical Service Behavior Norms in the Context of DRG Payment
——Based on Structural Equation Model
作者:
杨 松1钟艳红1王 绪2钟开全3吴婧文3陈 军4顾 强5朱旭林6李锦渊6彭美华6
1.成都医学院第三附属医院·成都市郫都区人民医院,四川 成都 611730
2.眉山市医疗保障局,四川 眉山 620860
3.眉山市医疗保障事务中心,四川 眉山 620037
4.中国人民财产保险股份有限公司眉山市分公司,四川 眉山 620000
5.成都市温江区人民医院,四川 成都 611130
6.成都中医药大学管理学院,四川 成都 611137
Author(s):
YANG Song ZHONG Yanhong WANG Xu ZHONG Kaiquan WU Jingwen CHEN Jun GU Qiang ZHU Xulin LI Jinyuan PENG Meihua
The 3rd Affiliated Hospital Of Chengdu Medical College·Pidu District People's Hospital, Chengdu Sichuan 611730, China
关键词:
DRG临床医生医疗服务行为结构方程模型
Keywords:
DRG clinical doctors medical service behavior structural equation model
分类号:
R19
文献标志码:
A
摘要:
目的:通过对M市临床医生开展问卷调查,了解临床医生对DRG付费改革的认知程度、价值认同,探究认知程度与价值认同对医疗服务行为规范的潜在影响。方法:采用Amos 24.0软件建立临床医生医疗服务行为规范影响因素的结构方程模型。结果:政策认知对感知价值具有正向影响,政策认知和感知价值对行为规范具有正向影响,感知价值在政策认知和行为规范中具有中介作用。结论:通过优化DRG付费政策、建立医院和医保的沟通渠道、丰富培训内容,深化医生对DRG付费政策的认知,规范医疗服务行为,实现医保支付方式改革的有序推进和医院的高质量发展。
Abstract:
Objective The clinical doctors in M city were surveyed through a questionnaire, to understand the cognitive level and value identification of clinical doctors towards DRG payment reform, and to explore the potential impact of cognitive level and value identification on medical service behavior norms. Methods A structural equation model was established using Amos 24.0 software to explore the influencing factors of clinical doctors' medical service behavior norms. Results Policy cognition has a positive impact on perceived value, while policy cognition and perceived value have a positive impact on behavioral norms. Perceived value plays a mediating role in policy cognition and behavioral norms. Conclusion We should optimize DRG payment policies, establish communication channels between hospitals and medical insurance, enrich training content, deepen clinical doctors' understanding of DRG payment policies, standardize medical service behavior, in order to achieve orderly promotion of medical insurance payment method reform and high-quality development of hospitals.

参考文献/References:

[1] 陈欣,王洁,钱宁,等.基于结构方程模型的全科医生职业认同感的形成机制研究[J].中国全科医学,2019,22(20):2506-2513.
[2] 王丹,王征兵,娄季春,等.牧户对草原生态补奖政策认知与评价[J].西北农林科技大学学报(社会科学版),2019,19(5):88-97.
[3] 谭永忠,练款,俞振宁.重金属污染耕地治理式休耕农户满意度及其影响因素研究[J].中国土地科学,2018,32(10):43-50.
[4] 刘保平,刘向玲,龙云.农业面源污染治理中政策认知对农户耕地质量保护行为的影响——基于湖南省衡阳市田野调查的研究[J].南华大学学报(社会科学版),2021,22(2):95-104.
[5] Zeithaml V A.Consumer perceptions of price,quality and value: A means-end model and synthesis of evidence[J].Journal of Marketing,1988,52(3): 2-22.
[6] 宋瑞敏,朱丽惠.感知价值对消费券使用意愿的影响研究——基于双中介效应模型的分析[J].价格理论与实践,2021(5):149-152,195.
[7] Gronroos C.Value-driven relational marketing:from product to resource and competences[J].Journal of Marketing Management,1997,13(5): 407-409.
[8] 杨棋,庚硕,刘瑾,等.公立医院RBRVS与DRG管理工具结合应用的思考——基于绩效管理视角[J].卫生经济研究,2021,38(3):57-58,62.
[9] 张钰婉,谈在祥.DRG支付背景下公立医院运营管理问题与对策研究[J].中国医院管理,2022,42(1):49-52,56.
[10] 吴海波,刘统银,朱文芝.基本医疗保险控费模式比较研究[J].卫生经济研究,2019,36(10):36-39.
[11] 陈姬雅,娄雪萍,王蓉蓉,等.数字医疗推动DRG点数支付改革的精细化管理[J].卫生经济研究,2021,38(12):72-74.
[12] 董乾,房耘耘,石学峰.DRG对医疗机构运行状况的影响研究[J].中国医院,2021,25(12):69-71.
[13] 刘菊梅,刘靖,吴利纳.基于DRG的综合管理措施对阑尾炎手术患者控费作用效果评价[J].中国卫生经济,2021,40(4):82-84.
[14] 李秀梅,刘理,胡海源,等.DRG支付下脑卒中患者住院费用控制研究[J].卫生经济研究,2022(1):44-47.
[15] 徐伟伟,胡振产.医保支付制度改革的“浙江范式”[J].卫生经济研究,2021,38(12):3-6,10.
[16] 李君,冯芮华,刘双梅,等.基于不完全契约理论的DRG付费方式改革对医院行为影响研究[J].中国医院管理,2020,40(8):17-20.
[17] 马燕.DRG支付方式改革对医生医疗行为的影响研究[J].中国当代医药,2021,28(21):205-208,213.
[18] 杨燕绥,常焙筌,秦晨,等.医保复合型付费的“约束-引导-激励”机制研究——契约科学和社会治理下金华医保改革实践[J].卫生经济研究,2021,38(12):7-10.
[19] 陆烨,和秋燕.丽江市M医院实施DRG调查分析[J].劳动保障世界,2020(18):38-39,42.
[20] 程国良,姜立艳,王勇,等.临床医师对DRG付费方式改革认知及需求情况调查[J].中国医疗保险,2021(1):66-68.
[21] 庄磊雪,杨建超,李志超,等.基于结构方程模型的日间手术向日归手术发展的影响因素分析[J].华西医学,2022,37(2):182-188.
[22] 张昕明,弓棣,谢秉磊,等.计划行为理论视角下基于出行行为的公交防疫策略影响效果研究[J].交通信息与安全,2021,39(6):117-125.
[23] 杨松,吴婧文,余丽君,等.DRG高倍率病例现状与政策优化思考[J].卫生经济研究,2022,39(4):24-27,32.
[24] 杨巧,陈登菊,张伟,等.医疗机构人员对CHS-DRG付费的认知现状及学习需求[J].医学与社会,2022,35(5):96-101.
[25] 朱旭林,龚熠,郭丽娟,等.医保基金监管的方式、成效与困境[J].卫生经济研究,2021,38(9):49-52.

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更新日期/Last Update: 2023-06-30