Study On The New Type Social Role Expectation Of Public Hospital By Different Group Based On The Role Theory

Objective:This study used the concepts of social role theory.To analyze the connotation of public hospital role expectation under the background of "healthy Chinese construction" and the expectation of the role of public hospitals.To explore the differences between the role expectation and the role comprehend on public hospitals.The purpose was to provide a reference for public hospitals to build a social role.At the same time,help medical reform,maintain the public hospital public welfare and improve the modern public hospital management system to provide a reference.Methods:According to the level of economic development,three provincial,three municipal,three county-level public hospitals,three institutions,three communities,one university and one township health center as a survey point were selected from Shanxi Province.Based on the role theory of Tiber and Kelly combined with the principle of Likert scale,we designed questionnaire which included 4 dimensions,17 first-level indicators and 74 second-level indicators,including public hospital culture,service,guarantee and social responsibility.In April to October of 2016,we investigated two groups,the public and the medical staff.The public group investigated 2694(84.0%),including the government staff 435(13.5%),public institutions staff 350(10.9%),enterprise staff 584(18.2%),urban residents 159(5.0%),rural residents547(17.1%),teachers 550(17.1%)and others 69(2.2%).The medical staff group investigated 514(16.0%),including hospital administrators 150(4.7%),health care workers 364(11.3%).There were 3208 questionnaires available and effective recovery rate of 97.2%.Through the personnel training,examination and approval,data entry and error screening four links to strengthen the whole process of quality control.The EpiData3.1 and SPSS22.0 software were used to establish the database.The effective data were processed by t test,analysis of variance and regression analysis,to analyze the status of public hospital role expectation.Results:1.Validity and ReliabilityThe indicators of reliability: The Cornbrash Alpha of the total expectation was 0.943,the cultural expectation was 0.944,service the service expectation was 0.907,the guarantee expectation was 0.907 and the social responsibility expectation was 0.894.The Split-half reliability of the total expectation was 0.882,the cultural expectation was 0.767,service the service expectation was 0.887,the guarantee expectation was 0.821 and the social responsibility expectation was 0.894.The indicators of validity: RMR of each dimension was below 0.08.The NNFI,CFI and GFI were above 0.9.The results showed that the reliability and validity had reached a good level.2.Role expectation(1)The public hospital cultural expectations: Different income,different places of residence,different age groups in the cultural expectations of different dimensions have significant differences.The scores of residents in rural areas were higher than those in urban residents(P <0.05).The old group over 61 age got higher scores than those of other age groups(P<0.05).With the increase of income level,the expectation of professional ethics also increased(P <0.05).(2)The public hospital service expectations: The scores of rural residents were higher than those of urban residents(P <0.05).There were significantly differences in all the dimensions except humanistic care in different age groups(P<0.05).Low-income and high-income groups had high expectation for public hospital service(P <0.05).(3)The public hospital social responsibility expectations: There were significant differences among the different age groups(P <0.05),the old had higher expectations(P <0.05).Low-income groups also had higher expectations(P <0.05).(4)The public hospital guarantee expectations: The coverage of the indicators of the dimensions were more than 4 points,indicating that guarantee expectations of medical staff on the public hospital were high,then the working environment,government support and employee benefits were the highest degree of expectations.3.Role comprehension(1)Between medical staff and public,there were significant differences in scientific research,the medical staff get higher than public(P<0.05).There were differences in medical care,humanistic care and medical technology,and the public is higher than that of the medical staff(P<0.05),which reflects that the role comprehension of public hospital is not enough.There were no differences in the social responsibility expectations of the public hospitals.(2)Regression analysis showed that the working environment,government support,employee performance,hospital image and employee benefits entered the final equation.The 67% changes of dependent variable can be explained by the five independent variables.Every one point increased in working environment,government support,employee performance,hospital image and employee benefits,the understanding of the social role of the public hospital would increase 4.494 points,1.899 points,1.197 points,2.045 points and 1.686 points.Conclusion:1.Role theory was developed in the construction and development of public hospitals.This paper used the role theory to analyze the role expectation of public hospital and its four aspects including culture,service,guarantee and social responsibility,and summed up the indicators with the highest expectation of public hospital role,which was the innovation management,professional ethics,humanistic care,medical technology,medical care and social welfare,enriched the public hospitals expectations.2.Role expectations are important to character behavior.The deficiency of role comprehension mainly concentrated in the hospital services.The low-income,the old and the rural residents had higher expectations.Therefore,in the construction and development of public hospitals,it should pay attention to its high social role expectations and lack of role comprehension,while paying more attention to rural residents,the elderly,low-income groups and other key groups of health problems.3.To enhance the role of comprehension is a clear role in positioning,standard role in the effective way.The results showed that we could improve the environment of work and the support of government to enhance the role comprehension.At the same time,to improve the correct understanding of public about the public hospital,to achieve the same role of the hospital,to enhance internal and external interaction,to accomplish the practice of role,to strictly respect for law and law,to regulate the behavior of role.