门诊患者就医获得感多元主体协同治理模型构建与实证研究

Construction and empirical study of multi-agent collaborative governance model for outpatients’sense of access to medical treatment

目的探究医疗服务体系多元主体互动关系及其治理作用,为有效提升患者就医获得感提供理论支撑。方法选取杭州市不同类型公立医院门诊患者作为研究对象,使用定额抽样方法开展问卷调查,利用结构方程模型对研究假设进行验证。结果经统计学检验与路径修正显示模型具有良好的拟合度,政府部门管理、医院内部管理、医务人员服务及患者认知态度对就医获得感均产生正向影响,影响的总效应分别为0.71、0.63、0.38、0.12。结论构建以政府部门为引领,公立医院为载体,医务人员为主轴,患者为中心的多元主体协同治理模式,是实践人民共建共享,有效提升就医获得感的关键策略之一。

Objective To explore the interaction between multiple governance subjects of the medical service system and their governance roles,and to provide theoretical support for the effectively enhancing of patients’sense of access to medical care.Methods Outpatients of different types of public hospitals in Hangzhou were selected as the research objects,questionnaire surveys were conducted using quota sampling method,and hypotheses and models were verified using structural equation modelling technology.Results Statistical tests and path correction showed that the model had a good fit,and that the management of government departments,internal management of hospitals,service of medical staff,and cognitive attitudes had a positive impact on the sense of access to healthcare,with total effects of 0.71,0.63,0.38,and 0.12,respectively.Conclusion The construction of a collaborative governance model that takes government departments as the leader,public hospitals as the carrier,medical staff as the center axis,and patients as the centre is the best way to practice a collaborative governance model of various subjects,and is an excellent way to practice a collaborative governance model of various subjects.The synergistic governance model of various subjects is one of the critical strategies to practise people’s co-construction and sharing and to enhance the sense of access to healthcare effectively.