摘要
目的:采用解释结构模型方法构建医疗挤兑危机驱动因素的多级递阶结构模型并识别各驱动因素间的作用关系,为防范和化解医疗挤兑危机提供建设性策略。方法:采用文献检索法和专家咨询法,识别并归纳医疗挤兑危机的驱动因素。采用解释结构模型法,建立医疗挤兑危机驱动因素的作用机制。结果:医疗挤兑危机的19类驱动因素是一个“四阶梯结构”,其中风险防控体系构建水平和医疗卫生体系协同程度是驱动医疗挤兑危机形成的根源层因素,危机监测预警能力、卫生应急知识储备和危机风险评估能力是中间层因素,事件危害程度、事件可控程度等14个因素是表象层因素。结论:医疗挤兑危机主要受19项驱动因素的影响,各驱动因素之间存在直接或间接关系,所处层级不同其发挥的作用也不同。
Objective To construct a multi-level hierarchical structural model of the driving factors of medical run crisis by using the explanatory structural model method,and identify the relationship among the various driving factors,so as to provide a constructive strategy for preventing and resolving the medical run crisis.Methods Literature retrieval and expert consultation method were used to identify and summarize the driving factors of medical run crisis.The explanatory structural model method was used to establish the mechanism of the driving factors of medical run crisis.Results The 19 driving factors of medical run crisis are a four-step structure",in which the construction level of risk prevention and control system and the degree of coordination of medical and health system are the root factors driving the formation of medical run crisis,the crisis monitoring and early warning ability,health emergency knowledge reserve and crisis risk assessment ability are the intermediate layer factors,and 14 factors such as the degree of event harm and the degree of event controllability are the surface layer factors.Conclusion The medical run crisis is mainly affected by 19 driving factors,each of which is directly or indirectly related and plays a different role at different levels.Author's address School of Health Management,Harbin Medical University,Harbin,P.R.China.
作者
柳小玉
宁宁
张鑫
齐越
于冰艳
张璐澔
Liu Xiaoyu(School of Health Management,Harbin Medical University,Harbin,P.R.China)
出处
《中国卫生事业管理》
北大核心
2024年第2期166-170,共5页
Chinese Health Service Management
基金
国家自然科学基金面上项目“灾难性医疗需求激增情景下卫生系统‘韧性’的理论与评价研究”(71874044)
黑龙江省自然科学基金项目“后疫情时代医疗挤兑风险动态演化机制及韧性治理策略研究”(LH2021G016)。
关键词
医疗挤兑危机
解释结构模型
驱动因素
medical run crisis
explain structural models
driving factors
