中国医院管理2024，Vol.44Issue(7) ：11-15.

多维组态视域下消极防御性医疗影响因素分析

Analysis of Influencing Factors of Negative Defensive Medicine from the Perspective of Multidimensional Configuration

刘雅萍 刘俊萍 邹丹丹 赵娟 张环宇 刘沼悦 尹新乐 梁立波
中国医院管理2024，Vol.44Issue(7) ：11-15.
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  • NETL
  • NSTL
  • 万方数据

多维组态视域下消极防御性医疗影响因素分析

Analysis of Influencing Factors of Negative Defensive Medicine from the Perspective of Multidimensional Configuration

刘雅萍 1刘俊萍 1邹丹丹 2赵娟 3张环宇 1刘沼悦 1尹新乐 1梁立波1
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作者信息

  • 1. 哈尔滨医科大学卫生管理学院 黑龙江哈尔滨 150081
  • 2. 复旦大学附属金山医院 上海 201508
  • 3. 陆军军医大学第一附属医院 重庆 400038
  • 折叠

摘要

目的 通过探索消极防御性医疗行为产生的条件组态效应,解释消极防御性医疗的形成机制和因果路径,为消极防御性医疗行为提供系统化建议,从而提高卫生资源的合理利用率.方法 采用必要条件分析和模糊集定性比较分析探究消极防御性医疗产生的条件组态,输出条件构型,进一步分析影响因素间的组态效应.结果 体制机制、机构规范、社会文化、医患关系、自我效能是消极防御性医疗的前因条件,通过组态分析发现共有两种形成消极防御性医疗行为的原因构型,分别是环境传导型和效能—环境联合传导型,两条路径的总体一致性为0.830.结论 减少消极防御性医疗行为应注重改善制度环境,提高医生自我效能,建立公平、合理的外在制度环境,营造诚信、和谐的文化氛围,加强医生职业能力的培养以及改善医患关系,从而提高卫生资源的合理利用.

Abstract

Objective By exploring the conditional configuration effect of negative defensive medicine behavior,the formation mechanism and causal path of negative defensive medicine are explained,and systematic suggestions are provided for negative defensive medicine behavior,so as to improve the rational utilization of health resources.Methods NCA and fsQCA are used to conduct configuration analysis on factors influencing passive defensive medical behavior,output the conditional configuration,and further analyze the configuration effects among the influencing factors.Results The antecedent conditions of negative defensive medicine include systemic mechanisms,institutional norms,social culture,doctor-patient relationships,and self-efficacy.Ultimately,two paths contributing to passive defensive medical behavior emerge:environment conduction type and efficiency-environment joint conduction type,their consistency is 0.830.Conclusion To reduce the negative defensive medical behavior,it should pay atten-tion to improving the institutional environment and improving doctors'self-efficacy,establish a fair and reasonable external institutional environment,create an honest and harmonious cultural atmosphere,strengthen the training of doctors'professional ability and improve the doctor-patient relationship,so as to improve the rational use of health resources.

关键词

消极防御性医疗/影响因素/组态

Key words

passive defensive medical/influence factor/configuration

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基金项目

国家自然科学基金项目(71974049)

国家自然科学基金项目(71673073)

国家自然科学基金项目(72274047)

出版年

2024
中国医院管理
中国医院管理杂志社

中国医院管理

CSTPCD北大核心
影响因子：2.15
ISSN：1001-5329
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