按病种分值付费改革背景下医务人员政策认知、感知价值对行为规范的影响

Influence of medical staff’s policy awareness and perceived value on diagnosis and treatment behavioral norms in the context of the Diagnosis⁃Intervention Packet reform

为探索按病种分值付费(diagnosis-intervention packet,DIP)改革后的医务人员政策认知、感知价值对行为规范的影响,该研究于2023年10—11月采用方便抽样的方法,对L市300名医务人员进行问卷调查。采用PROCESS程序中的Model 4检验感知价值对政策认知和行为规范关系间的中介作用。结果表明,医务人员的政策认知得分为(19.24±5.87)分,感知价值得分为(42.99±12.48)分,行为规范得分为(31.25±6.06)分。多因素线性回归分析表明,医务人员的政策认知、感知价值正向预测行为规范。中介效应检验表明,感知价值在医务人员的政策认知水平和行为规范之间起到部分中介作用,中介效应占比为58.06%。医务人员对DIP改革政策认知得分越高,政策感知价值越高,从而进一步规范诊疗行为。

This study conducted a questionnaire survey of 300 medical staff in L City on policy awareness,perceived value,and diagnosis and treatment behavioral norms after the Diagnosis-Intervention Packet(DIP)reform in October-November 2023 using a convenience sampling method to explore the impact of policy awareness and perceived value on medical staff’s diagnosis and treatment behavioral norms after the DIP reform.Multifactor linear regression and Bootstrap methods were used to test the mediating role of perceived value on the relationship between policy awareness and diagnosis and treatment behavioral norms.The results showed that medical staff scored(19.24±5.87)for policy awareness,(42.99±12.48)for perceived value,and(31.25±6.06)for diagnosis and treatment behavioral norms.Multifactor linear regression analysis showed that medical staff’s policy awareness and perceived value positively predicted diagnosis and treatment behavior.In addition,Bootstrap results indicated that perceived value partially mediated the relationship between medical staff’s policy awareness and diagnostic and treatment behavioral norms,with a mediating effect of 58.06%.Therefore,the higher the medical staff’s DIP reform policy awareness score,the higher the perceived value of the policy,further regulates the norms of diagnosis and treatment behaviors.