基于扎根理论的天津市基层医疗机构卫生应急能力提升研究

Study on Improving Health Emergency Capability of Grassroots Medical Institutions in Tianjin Based on Grounded Theory

目的:应用扎根理论方法,探讨天津市基层医疗机构疫情防控存在的问题,并提出卫生应急能力提升策略,为基层卫生健康管理与应急管理融合发展提供参考。方法:对12名天津市基层医疗机构工作人员进行深度访谈,通过三级编码分析,构建基层医疗机构卫生应急能力模型。结果:资源禀赋、组织管理和协同领导3个主范畴共同影响基层医疗机构卫生应急能力及其各内部因素间联结关系的强度和方向。基层医疗机构工作人员广泛关注的问题与真实存在的问题可能存在偏差,基层医疗机构的责任意识缺失会导致其工作人员产生心理压力。结论:天津市基层医疗机构卫生应急能力受资源禀赋、组织管理、协同领导共同影响,应提升基层医疗机构卫生应急资源禀赋,推进卫生应急协同领导,强化卫生应急组织管理,化解基层医疗机构在疫情防控中存在的系统性风险,进而提升疫情防控整体效果。

Objective:To explore the problems of epidemic prevention and control in grassroots medical institutions in Tianjin,and to propose strategies for improving health emergency capability by applying grounded theoretical method,so as to provide references for the integrated development of grassroots health management and emergency management.Methods:The in-depth interviews with 12 staff members of grassroots medical institutions in Tianjin were conducted,and the model of grassroots medical institutions"health emergency capabilities through three-rank coding analysis was constructed.Results:The three main coding including resource endowment,organization management and coordinated leadership affected the strength and direction of the grassroots medical institutions"health emergency capabilities and their internal factors together.The widespread concern of staff members of grassroots medical institutions might deviate from the real problems.The lack of sense of responsibility of grassroots medical institutions caused their staff to face the psychological pressure.Conclusion:The health emergency capability of grassroots medical institutions in Tianjin is influenced by resource endowment,organization management and coordinated leadership.The endowment of health emergency resources in grassroots medical institutions should be improved,the collaborative leadership of health emergency should be promoted,and the organization management of health emergency should be strengthened.The systemic risks in epidemic prevention and control of grassroots medical institutions should be resolved,thereby improving the overall effect of epidemic prevention and control.