Division And Cooperation Mechanism Of Medical Institutions And Its Implementation Strategy Under The Background Of Grading Treatment

The establishment of division and cooperation mechanism in medical institutions is an important measure to speed up the construction of grading treatment system,optimizing the rational allocation of medical resources and promoting the fair and accessible basic health services.It is also an important part of deepening the reform of the health system,and improving the livelihood of the people by the party and the state.However,in the process of the market economy reform,kinds of medical institutions tend to show competitive relations,which were used to induce demand,or selective provide health services.In addition,with the incresement of residents’ income,their demand for health also increased accordingly.Hencefully,they will neglect the primary primary medical service while choose directly to the urban comprehensive hospital,which aggravated the problem of labor division and cooperation in medical institutions.Therefore,under the background of insufficient health resources,non-cooperation of medical institutions,the increasing income of residents and the demand for health,how to coordinate the behavior strategies among the stakeholders in the process of labor division and cooperation in medical institutions and meeting the interests of all stakeholders were the main purpose of this study.For this reason,this study identified three key stakeholders that influence the division and cooperation of medical institutions,then carried out the behavior game relationship among key stakeholders in the process of division and cooperation of medical institutions,the mechanism from the perspective of key stakeholders and the results of cooperation from the perspective of key stakeholders and the satisfaction of key stakeholders.The main results are as follows:(1)The government,the managers of urban comprehensive hospital and the patients are the key stakeholders,which influent the division and cooperation in medical institutions in maximum degree.This study selected the main skateholders by theory research method and expert scoring method.Then,we used the Mitchell 3D attribute classification method to score ten main stakeholders screened from 3 dimensions: legitimacy,importance and urgency.Finally,the government,the managers of urban comprehensive hospital and the patients were recognized as the key stakeholders of division and cooperation in medical institutions.(2)The focus of the objectives of the division in medical institutions lies in the joint participation of the key stakeholders.The government,the managers of urban comprehensive hospital and the patients as a rational economic man,any strategy choice will affect and be affected by the strategy choices of the other two types of stakeholders.Hencefully,the joint participation of government,the managers of the urban comprehensive hospital and the patients is necessary for promoting the division and cooperation of medical institutions.Although the countermeasures can not achieve the maximized interest for the key stakeholders,it can balance the interest demand of each key stakeholder,so as to improve the overall benefit.(3)The government is committed to the division and cooperation in medical institutions,but the benefit claims among stakeholders have not been coordinated and satisfied.The division and cooperation of medical institutions promoted the increasement of service volume and efficiency of basic medical institutions in Zhenjiang,and the collaboration and connection between different primary medical institutions.There were also existed problems such as the lack of medical and health resources at the primary medical institutions,unbalance of development and irrational increasement of medical expenses in urban comprehensive hospitals and so on.In terms of satisfaction,the enthusiasm of medical staff between the two medical groups of Zhenjiang were not high enough to participate in the division and cooperation of medical institutions,the awareness rate of patients on division and cooperation of medical institutions and the trust degree of medical service quality of primary medical institutions were not high.In view of the above research contents,the main conclusions of this study were listed as follows: the implementation path of division and cooperation in medical institutions can be proposed by each key stakeholder.Combine the theoretical analysis and the case study,the fairly and righteous guiding path by the government,the participation path of clear responsibility by the urban comprehensive hospital,and the reasonable and effective selection path by the patients were proposed by the key stakeholders.It also proposed the linkage integration collaboration path by other stakeholders,which aims to provide theoretical reference and strategy suggestions for the division and cooperation among medical institutions and the construction of the system of classification diagnosis and treatment in China.