新医改下社区卫生服务机构的行为逻辑——基于扎根理论视角的研究

Behavioral logic of community health service institutions in the background of the new healthcare reform based on the grounded theory

社区卫生服务机构是医疗卫生服务体系的网底,关系到医疗卫生服务的质量与体验。本文聚焦新医改背景之下社区卫生服务机构的行为逻辑,通过分析社区卫生服务机构行为来透视医疗卫生体制改革引致的基层实践情况,通过对N市社区卫生服务机构的访谈数据,以扎根理论方法来构建起社区卫生服务机构的行为逻辑特征。研究发现,公益性导向在社区卫生服务机构的实现,需要内、外部共同协调下得以完成,在利益、定位、激励、资源要素之间的改革协同程度将决定着社区卫生服务机构行为导向与基本运作实践,本研究将对认知与优化医疗卫生体制改革政策具有参考价值。

Community health service institutions are the basic tentacles of medical services which directly indi- cates their relation to the quality and experience of health service. This paper focuses on the behavioral logic of com- munity health service institutions under the background of new medical reform, and looks forward to a perspective on the grassroots practice caused by the reform of medical system through the behavioral analysis of the community health service institutions. The behavioral logic features of the community health service institutions were constructed based on the interview data Nanjing City using the grounded theory. It was found that the realization of public welfare orien- tation of the aforesaid institutions needs to be completed under the internal and external coordination. The degree of coordination among the interests, orientation, incentives and resource elements will determine the behavior orientation and basic operational practices in the community health service institutions. This study will provide a reference value for the cognition and optimization of heahhcare reform policies.