Study On Synergy Capabilities Of Public Medical Group In China

[Purpose]Combined with synergy theory, organizational structure theory, and enterprise capabilities theory, based on analysis of the developing history, structural models, operating status and internal and external environment of public medical group, the synergy elements have been extracted, the synergy capability levels and critical synergy elements has been determined, the framework and theoretical model of public medical group synergy capability system have been constructed and validate, and the synergy capability of public medical groups has been analyzed deeply from the view of systematic synergy. The synergy capability index of public medical group has been measured, and the constructive strategies have been purposed. The study has founded the theoretical research basis for the research of public medical group synergy, and provided theoretical foundation, practical guidance and policy recommendations for improving the synergy capability of public medical group in China.[Methods](1)Literature Analysis:search and collect the literatures on the research and practice of enterprise group theory, synergy theory, theory of enterprise capabilities, organizational structure theory and so on, as the basis of theoretical study on synergy capability of public medical group in China. Through searching relative journals, academic works and other materials, analyze the developing status of public medical group in China.(2)SWOT Analysis:analyze the internal and external environment of the developing of public medical groups in China, using the method of AHP-SWOT. And then, research on the strengths, weakness, opportunities and threats of it. According to the result, draw the comprehensive SWOT analysis chart, and propose respective strategy for it.(3) Construction of theoretical model on synergy capability of public medical group:120managers in public medical groups have been investigated, and the data has been analyzed in the method of factor analysis. Extract, select and demonstrate the elements affecting the synergy capability of public medical groups, and then determine the critical elements and synergy levels.(4) Measurement study and Model verification on the synergy capability of public medical group in China:select10public medical groups in eastern, central and western regions in China, and questionnaires have been assigned to400managers and senior staff in these groups. Use the data to test reliability and validity of the model, and construct second-order factor analysis model and structural equation model (SEM) to validate and analyze the model deeply.(5) Composite index study of synergy capability of public medical group in China: select3different modes of public medical groups as the typical cases, investigate and analyze their operating status in the methods of informant interviews and questionnaires. Analyze the indexs of their synergy capabilities quantitatively in the method of composite index analysis.[Results](1) According to the literature analysis and theoretical analysis, the concept of synergy capability of public medical group has been defined as an open system with self-organization, which also follows the principle of synergy theory. And the organization structure of hospital medical group would affect its synergy capability, which is public medical group’s core competency.(2)Through analyzing and combing the developing of public medical groups in China, it is found that the public medical groups in China have experienced four stages:budding, rising, rapid developing before healthcare system reform, and coordinative developing after the reform. Some results have been achieved within the formation of public medical groups, accompanied with which there are also many problems. According to the levels of groups’ members, the public medical groups could be classified to horizontal medical groups and vertical medical groups. According to the collaborative relationship between groups’ members, the public medical groups could be classified to compact, semi-compact and loose type. According to the regions of groups’members, the public medical groups could be classified to urban medical institutions combination, county region medical institutions linkage, urban hospital and county hospital counterpart unit, and province region medical institution league. According to SWOT analysis, it is found that the current developing status of public medical groups is in the stage of good internal and external environment. As the result, it could adopt SO strategy (strength and opportunity), and ST strategy (strength and threat).(3) Constructing theoretical model of the synergy capability of public medical group. The synergy capability of public medical group is constituted by macro, meso and micro levels, and ten synergy capability elements. Macro synergy capability is a leading force, which is constituted by strategy synergy element and culture synergy element. Meso synergetic capability is a integrating capability constituted by system synergy, information synergy, resource synergy, and organization synergy elements. Micro synergetic capability is an synthesizing capability constituted by innovation synergy, compact synergy, medical business synergy, and process synergy elements. Through the interaction and collaboration of different levels and different elements, the synergetic capability of public medical groups could be formed, which could improve the benign developing of medical groups.(4) According to the second-order factor analysis model, it could be found that there are three endogenous latent variables to the exogenous latent variable of synergy capability. The three endogenous latent variables and their standard parameter values are:macro synergy capability (0.89), meso synergy capability (0.97), and micro synergy capability (0.88). It is also verified that the synergy capability of public medical groups are constituted by macro, meso, micro synergy capacities. For macro synergy capability, the two observed variables and their standard parameter values are:culture synergy (0.843), strategy synergy (0.844). For meso synergy capability, the four observed variables and their standard parameter values are:system synergy (0.854), information synergy (0.849), resource synergy (0.804), organization synergy (0.827). For micro synergy capability, the four observed variables and their standard parameter values are:innovation synergy (0.849), compact synergy (0.756), business synergy (0.716), process synergy (0.779). Conclusively, from the above results, the constitution of theoretical model of synergy capability of public medical groups is reasonable.(5) The structural equation model (SEM) of synergy capability of public medical groups has been constructed, and according to the pathway relationship between the different variables, it could be found that macro, meso, and micro synergy capacities are correlative significantly, at the level of p=0.05. As a result, the synergy capability of public medical groups couldn’t be improved on only one level. The relevance between macro synergy capability and meso synergy capability is largest (standard regression coefficients=0.848), followed by the relevance between meso synergy capability and micro synergy capability(standard regression coefficients=0.815). The relevance between macro synergy copacity and micro synergy capability is the third (standard regression coefficients=0.786)(6) According to the theoretical model of the synergy capability of public medical group, through the investigation and analysis of three modes of public medical groups(close mode, half-close mode and loose mode), it is found that score of comprehensive index of synergy capability of close mode is0.8428and the synergy capability is good, score of comprehensive index of synergy capability of half-close mode is0.7509and the synergy capability is at moderate level, core of comprehensive index of synergy capability of loose mode is0.5766and the synergy capability is weak.[Conclusions](1) Public medical groups follow the principle of synergy theory and needs synergetic development. Synergy capability is core competency of public medical groups. Public hospital groups have many kinds of organization structures and they are having experienced some key problems and challenges in the process of synergetic developing, needing to improve synergy capability.(2)The synergy capability of a public medical group is constituted by macro, meso and micro levels, and ten synergy capability elements. Macro synergy capability is constituted by strategy synergy element and culture synergy element. Meso synergetic capability is constituted by system synergy, information synergy, resource synergy, and organization synergy elements. Micro synergetic capability is constituted by innovation synergy, compact synergy, medical business synergy, and process synergy elements. Public hospital groups’macro, meso, and micro synergy capacities are positive correlative significantly. Through the interaction and collaboration of different levels and different elements, the synergetic capability of public medical groups could be formed, which could improve the benign developing of medical groups.(3)Public hospital groups with different modes and organization structures modes have different synergy capability. The synergy capability of close mode is the best, the synergy capability of half-close mode is at moderate level, the synergy capability of loose mode is weak.(4)To improve the synergy development of public medical groups, the legal system and policy support should be fastened, in the level of government. Public medical groups should select organized mode according to actual situation, improve governance structure and operating ways, establish internal collaborative mechanisms, clarify the relationships and positions, roles and responsibilities, divisions and cooperation of groups’members, in the level of public medical group. To improve the whole synergy development of public medical groups, the macro, meso and micro synergy elements should be better collaborating.