The Promotion Strategy Research On Resource Integration Of Health Service System

1.PurposeThis study aims to provide countermeasures to promote resource integration of the health service system in China, on the basis of previous studies, and using system theory and development strategy theory, through the empirical research to discover the factors that affect resource integration of health service system,and based on the strategic process model of resource integration of the health service system, to establish the index system of resource integration of health service system, and doing systematic study on the resources integration of health service system.2.Research programs(a)Theory analysis of the research.(b)The status research and trend analysis of resource integration of the health service system.(c)An empirical study on the promoting resource integration of the health service system.(d)Constructing the strategic process model of resource integration of the health service system.(e)Establishing the index system of promoting resource integration of health service system.(f)Discover the existing problems and puts forward some countermeasures and suggestions.3.Methods(a)Literature analysis:through the journals, as well as the books,and the national or local documents about resource integration of the health service system, to understand the overall situation of current resource integration of health service system in China, and through use the BICOMB software system to do bibliographic co-occurrence for the relevant literature, in order to understand the deficiency of research at present.(b) Semi structured interviews:Through conducting the in-depth interviews to the dean or people who responsible for the hospital group reform work in hospital, to understand its ideas, attitudes and opinions on how to improve the resource integration of the health service system.(c) Cluster analysis and correlation analysis:This study adopts clustering method to explore the dimensions which effect the medical staff’s playing, and through the correlation analysis of the three dimensions of cognition, action and effect, to explore the mechanism of model how medical staffs play.(d) Multinomial logistic regression analysis:the research take the3indexes of V4, V6, V17in the effect dimensions as the dependent variable Y, and according to the mechanism model of which effect the medical staffs playing to select V1,V2, V3, V5, V7, V13, V14(including cognition, action) as X, using multi classification logistic regression analysis, to discuss the factors which affect the implementation effects of resource integration of health service system.(e) The thematic framework method:this study use the thematic framework method to do analysis of the qualitative interview data,to discover the The degree of importance of hospital managers.(f) The expert consultation method:in the preparation of expert advice sheet, choose24experts with years of hospital management and related research experience, after third wheel expert consultation and ultimately establishing the index system of resource integration of health service system, and uses AHP to determine the index weight.4.Results and Conclusions(a) The relevant theoretical analysis This study screened system theory, coordination theory, development strategy planning theory, PDCA cycle theory, cognitive theory, and discusses the theory’s role in the medical service system’s integration. First of all,"the coordination theory", emphasizing the coordination of the medical institutions in the three level health service system, the third level medical institutions should play its leading role to promote the development of the lower level medical institutions; second,"the development strategy planning theory", by reviewing the history, current situation, prospect analysis to determine the future development goals and direction of modern hospital; third,"the PDCA theory", the theory provides a new idea for the resources integration of medical service system; fourth,"the cognitive behavior theory", the theory is committed to improving the medical staffs identity and promote resource integration of health service system.(b)The status and trend analysis of medical service system resource integrationThis study summarizes the evolution and practice of resources integration of health service system in China and abroad, using the methods of Literature Metrology Analysis to do the keyword analysis of the literature on resources integration of health service system in domestic and abroad, draw that they lack of research on the process of resources integration of health service system,but emphasis on research on implementation effects, and this research intends to study the whole process of premise integration, the process of implementation and results in the final.(c)The analysis of the mode of action and factors analysis in the resources integration of health service systemThe study based on the theoretical model of medical staff cognitive behavior theory, using cluster analysis and the correlation test,and constructs the role play mechanism model of the medical staff, through the study on the influence factors of the three dimensions of the model which is cognition, action and effect, to provide specific recommendations to promote resource integration of the health service system for medical staff; interviews medical institutions by theme framework approach to management of qualitative analysis, final through the the three themes which are the premise of integration, the implementation process of integration,and the results of the resources integration to analysis the role.of management of medical institutions in the resource integration of health service system.(d)The strategic process model of the health service system resource integrationThis research uses the IDEFO modeling method, and follow the PDCA circulation principle, and gradually build top design model, and IDEFO model of four stage of PDCA, to explore how to to complete the whole process of strategic management through integrate various resources,and finally promote the resource integration of health service system.(e) The index system of resource integration of health service systemThis study constructed the index system of resource integration of health service system for3first level indicators,including The premise of the integration and coordination, the implementation process, and the outcome,13two level dimension and36three level indicators. Three rounds of expert consultation, the positive coefficient of experts all more than90%, shows that the expert’s enthusiasm is high; and the degree of expert authority was0.74, so the research has a good degree of expert authority.(f) Strategies and suggestionsIn this study, through theoretical and empirical analysis to put forward the following suggestions:first, change management system:to straighten out the management system of public hospitals; to establish the operational rules of service system in public hospital corporate governance. Second, a new model of medical service needs to be set up:to improve the "two-way referral system;" guide patients to change health habits; break the reasonable flow of doctor barriers. Third, the establishment and operation of the Medical Association:building top design, appropriate government decentralization; improve the internal management mechanism, operation mechanism; a full range of technical cooperation. Fourth, strengthen the guiding role of medical security system:strengthening the research, and gradually realize the classification of payment; strengthen the supporting system reform. Fifth, the role of government embody:implement fiscal subsidies policy; guide the establishment of "the first diagnosis system"; to strengthen the evaluation of the medical service system resources integrated. Sixth, promote the role playing of management and Ihe medical personnel of the hospitals:lead a correct guidance of the cognize of staff; positivly motivate the medical staff,and strengthen their actions; stimulate the enthusiasm of medical staff, promote resource integration effect; the medical institutions should strengthen the cognizance qualification of the dispatched staff and to carry out a comprehensive business.5.1nnovations(a) The new research angle of viewThis research considered the higher level medical institutions should play a role in the three medical service system,and towards on the process to promote the resource integration of the health service system.(b)Tthe innovation on theoretical researchThe "system theory","coordination theory" and "development strategy planning theory"were applied in the study of promoting the resource integration of the health service system, it’s using the theory to guide practice.(c) Practice innovationThis study use IDEFO method,and according to the PDCA circulation principle,to construct health service system resource integration index system, provides objective index for the check of the process operating and results of the resource integration of the health service system, also provide a realistic basis for the intervention of the medical staffs.