社区医生首诊服务动力形成机理及治理逻辑研究

Study of the formation mechanism and governance logic of the service motivation for community doctors' first contact

社区医生首诊服务能力及可持续发展动力无疑是当前推进基层首诊及分级诊疗制度建设的关键要素。本文通过对"动力"相关概念及发展的逻辑综述,并结合当前我国社区首诊服务以及社区医生角色特质分析,提出并界定了社区医生首诊服务动力的概念及内涵,在重点对构成社区医生首诊服务的引力、支持力、推力、压力等外在动力和由职业认同、自我效能和成就动机三维度形成的内生动力以及相互作用关系规律论证阐述的基础上,构建了以形象和直观为特征的社区医生首诊服务动力形成机理,为当前科学治理和提升社区医生首诊服务动力以及有效推进社区首诊制提供了可供探究的逻辑路径和依据。

The service capabilities and sustainable development of community doctors＆#39; first contact are undoubtedly the critical factors to promote the construction of grassroots clinics and tiered health care system.Based on the review of motivation-related concepts and its development, as well as the analysis of the current conditions of community first contact and characteristics of community doctors in China, this paper puts forward and defines the concept and connotation of service motivation for community doctors＆#39; first contact by logically summarizing the concept of ＆quot;force＆quot; in physical sciences ,＆quot;motivation＆quot; in service science, Based on analyzing the extrinsic motivations to form community doctors＆#39; first contact such as attraction, support, constraint, and stress the intrinsic motivations produced by professional identity, self-efficacy and achievement,as well as the interactions and relationships between them, this paper contructs a formation mechanism of the service motivation for community doctors＆#39; first contact, which is visual and intuitive.This paper provides a logical path and basis for scientific governance and upgrade of the service motivation for community doctors＆#39;s first contact to effectively promote community first contact system in China.