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基于fsQCA的三级公立医院高质量发展路径研究

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目的 探讨三级公立医院高质量发展路径,为深化公立医院改革提供参考.方法 基于SPO理论构建三级公立医院高质量发展分析框架,采集某省2023年三级公立医院绩效考核暨高质量发展某季度监测指标数据,以参与绩效考核的73家三级公立医院为分析对象,采用模糊集定性比较分析探索三级公立医院高质量发展的不同条件组态,揭示公立医院高质量发展路径.结果 高质量发展是多因素共同作用的结果,服务质量-技术驱动型路径、服务质量驱动型路径、综合服务驱动型路径、服务质量-效益驱动型路径是推动三级公立医院高质量发展的4种组态,其中,质量安全和功能定位2个条件变量是推动公立医院高质量发展的核心要素.结论 加强党建引领,并结合医院功能定位,以质量安全为核心,灵活调整和优化技术水平、人员结构、服务流程、费用控制等要素的组合条件,明确医院发展战略,贯彻动态理念,实现公立医院高质量发展.
Research on the High-Quality Development Path of Tertiary Public Hospitals Based on fsQCA
Objective To explore the high-quality development path of tertiary public hospitals and provide scientific reference for deepening the reform of public hospitals.Methods Based on SPO theory,it constructed an analytical framework for the high-quality development of tertiary public hospitals,collected data of a quarterly monitoring in-dex for the performance assessment and high-quality development of tertiary public hospitals in a certain province in 2023,and analysed 73 tertiary public hospitals participating in the performance assessment as the object of analy-sis,and adopted the fuzzy-set Qualitative Comparative Analysis to explore different condition sets of high-quality de-velopment of tertiary public hospitals and reveal the path of high-quality development of public hospitals.Results High-quality development is the result of multi-factor interaction.Four configurations were identified to promote the high-quality development of tertiary public hospitals:service quality-technology-driven path,service quality-driven path,comprehensive service-driven path,and service quality-benefit-driven path.Quality safety and functional orientation were found to be the core elements in promoting high-quality development of public hospitals.Conclusion Hospitals at all levels should strengthen the guidance of party building,combine with the actual functional positioning,take quality and safety as the core,and optimize the combination conditions of technical level,personnel structure,service process,and cost control.It is essential to clarify the development strategy of hospitals,implement the dynamic concept,and realize the high-quality development of public hospitals.

tertiary public hospitalhigh-quality developmentfuzzy-set Qualitative Comparative Analysis

徐娜、许凌烽、周立芳、牛俊婕、郎紫涵、吴逸轩、姜晓利、彭海波、尹文强、尹呈良、于倩倩

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山东第二医科大学管理学院 山东 潍坊 261053

山东第二医科大学公共卫生学院 山东 潍坊 260053

山东第一医科大学附属省立医院 山东 济南 250021

山东第二医科大学人事处 山东 潍坊 261053

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三级公立医院 高质量发展 模糊集定性比较分析

山东省自然科学基金项目教育部人文社会科学研究规划基金项目

ZR2023MG03622YJAZH138

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
年,卷(期):2024.44(10)