农村医疗服务纵向整合利益相关者实证研究

Empirical Research on Stakeholders of Medical Service Vertical Integration in Rural Area

医疗服务纵向整合涉及到不同利益主体之间的协调合作,因而受到利益主体态度和行为的深刻影响。通过多主体访谈和利益相关者分析,发现各利益主体在纵向整合中具有不同的整合诉求和期望,政府部门对整合的期望较大,推动意愿和动员资源的能力最强;患者、基层机构的利益诉求较大,对整合的阻碍作用相对较小,但动用资源的能力也小;区级医院对整合的期望强烈,动用资源的能力较强,但整合理念存在偏差。应综合利益相关者需求,综合其能力,因势利导,加大整合力度,消除阻碍因素,因地制宜推动我国农村医疗服务纵向整合实践。

The medical service vertical integration involves the coordination and cooperation of different interest subjects,so it is profoundly influenced by the attitudes and behaviors of stakeholders.Through the multi-agent interviews and stakeholder analysis,this paper finds that the various stakeholders have different demands and expectations to medical service vertical integration,in which the government departments have bigger expectations and stronger driving abilities to mobilize resources.The interests appeals of patients and medical institutions at the basic level are larger,whose negative impacts on service integration abilities to mobilize resources are relatively smaller and weaker.The integration expectations and ability to mobilize resources of county hospitals are stronger,but their conceptions of integration are deviated.Therefore,this article proposes to take considerations of the needs of stakeholders,increase the intensity of integration,eliminate obstacle factors,and adjust measures to local conditions to promote vertically integrated medical services practice in rural China.