松散型医联体赋能基层医疗服务体系——组织竞合、政策激励与动态能力提升

Loose Medical Consortium Empowers the Primary Medical Service System——Organization Competition and Cooperation,Policy Incentive and Promotion of Dynamic Capability

我国医联体建设主要有紧密型和松散型两种模式。目前普遍认为紧密型医联体比松散型医联体能更好实现政策目标,那么松散型医联体建设能否取得成效并赋能基层医疗服务体系?本文采用归纳式案例研究方法,应用组织竞合、政策激励和动态能力等理论分析浏阳市集里医院松散型医联体形成动因、运行机制和实施成效。研究发现,松散型医联体建设在实现医疗资源整合、医疗机构协作及赋能基层医疗服务体系等目标方面可以取得良好成效,主要原因在于松散型医联体通过建立竞合动力机制、外部激励约束机制、内部提质增效机制、动态能力提升机制,从而避免虹吸、形成协同、提高效率并获得竞争优势。本文提出"松散型医联体赋能基层医疗服务体系理论模型",丰富了医联体建设模式选择和运行机制的理论探讨,对松散型医联体建设赋能基层医疗体系的实践探索具有一定指导意义。

The objective of this paper is to explore whether the construction of loose medical consortium can achieve remarkable results and empower the primary medical service system.An inductive single case study was conducted,which intends to analyze the formation motivation,operation mechanism and implementation effect of the loose medical consortium of Liuyang Jili hospital by applying the theories of organization competition and cooperation,policy incentive and dynamic capability.The analysis based on this study reveals that the loose medical consortium can achieve good results in realizing the integration of medical resources,cooperation of medical institutions and the goals of empowering the primary medical service system.It is because the loose medical consortium establishes competition and cooperation mechanism,external incentive and constraint mechanism,internal quality and efficiency improvement mechanism,and dynamic ability promotion mechanism that it could avoid siphon effect,form synergy,promote efficiency and obtain competitive advantage.This study puts forward"the theoretical model of the loose medical consortium empowering the primary medical service system",which enriches the theoretical discussion on the construction mode selection and operation mechanism of the medical consortium,and has a certain guiding significance for the practical exploration.