医联体背景下贵州省县乡医院间合作关系、信任关系与合作效果的关联研究

Correlation Research of Cooperative Relationship,Trust Relationship and Cooperative Effect Between County and Township Hospitals in Guizhou Province in the Context of Medical Consortium

目的:分析贵州省县乡医联体伙伴之间的合作关系、信任关系与合作效果及其各维度之间的关系,为医联体建设提供决策依据。方法:通过对贵州省遵义市等5个市(自治州)48个县的基层卫生管理人员进行问卷调查收集数据,采用信效度分析、相关分析、线性回归分析对数据进行统计分析,并检验变量之间的关系。结果:合作关系对信任关系及其维度有显著的正向影响(P<0.001);合作关系对合作效果及其维度有显著的正向影响(P<0.001);信任关系和友善度对合作效果有显著的正向影响(P<0.001)。其中,信任度对合作效果及信息化沟通、分级诊疗、人才培养均有显著的正向影响(P<0.05),而可靠性对合作效果及其维度无显著的正向影响(P>0.05)。结论:我国在推进县域医联体建设过程中应考虑伙伴关系与信任关系对合作绩效的影响。在县乡医联体建设中应注重培育良好的伙伴关系,尤其应重视伙伴间信任关系的建立,并通过伙伴关系加强信任关系链接来提高县乡医联体的合作效果。

Objective:To analyze the cooperation relationship,trust relationship and cooperation effect among the partners of the medical consortium in county and township as well as the relationship among their dimensions,so as to provide the decision-making basis for the construction of the medical consortium.Methods:Data were collected through questionnaire survey of primary health managers in 48 counties of 5 cities(autonomous prefectures)including Zunyi city,Guizhou province,and the data were statistically analyzed by reliability and validity analysis,correlation analysis and linear regression analysis to test the relationship between variables.Results:Cooperative relationship had a significant positive impact on trust and its dimension(P<0.001),and cooperative relationship had a significant positive impact on cooperative effect and its dimensions(P<0.001),confidential relationship and friendliness had a significant positive impact on cooperative effect(P<0.001).Among them,trust had influence on cooperation effect,information communication,hierarchical medical care,and talent training(P<0.05),while reliability had no significant positive influence on cooperation effect and its dimensions(P>0.05).Conclusion:The influence of partnership and trust relationship on cooperative performance should be taken into account when promoting the construction of county medical consortium.The construction of county and township medical consortium should pay attention to the formation of good partnership,especially the establishment of trust relationship between partners,and strengthen the trust relationship though partnership to improve the cooperation effect between medical alliance of county and township.