Study On The Measures To Promote Legal Doctor Multi-sites Practice From Public Hospital Perspective

This study is proposed to find out the current situation of China’s doctormulti-sites practice, including the present situation of practising outside the hospitalin private,permited consultation out of hospital and medical multi-sited registration.Doctors are motivated to carry out mlti-sites practice when they value their practisingoutcomes (valence) according expectancy theory. Structural equation mode（SEM）is applied to analyzes affecting factors of practising outside the hospital inprivate,implementing permited consultation out of hospital and the physicianmulti-point licensed policy.In this research, taking public hospitals’ clinic chief physicians, associate chiefphysicians, and attending physicians in grade three A hospitals of Fujian province assamples, the six requirements doctors care most were obtained by free interview ofdoctors. According to the six requirements a questionnaire was designed and investedon the internet.203effective questionnaires were collected. SEM and regressionanalysis is applied to analyze the presentation performance of our country’s doctormulti-sited practice and the factors which influence the implementation of doctormulti-sited practice policy.There are five research results.(1) The results show that a modified expectancytheory with three components (expectancy, instrumentality and valence) best explainsprocess of motivating doctors to carry out multi-sited practice. Doctors’motivationhas a positive effect on their behavior.(2) The regression analysis results show themost important factor that affects doctors’motivation to practise outside the hospitalin private is instrumentality. Valence is the second of all the factors.(3) Theregression analysis results also show the most important factor that affects doctors’motivation carry out permited consultation out of hospital is Instrumentality.Valence is the second of all the factors.(4) The regression analysis results show themost important factor that affects doctors’motivation to carry out medical multi-sitedregistration is expectancy. Instrumentality is the second of all the factors.(5) Theresult dealt with by variance analysis way shows that compared with other ways tocarry out multi-sites pratice, the incidence rates of permited consultation out ofhospital is larger than those of other two ones. The ratio of medical multi-sitedregistration is the lowest in the results of questionnaire survey.Though the analysis of the construction of doctor motivation mechanism basedon the expectancy theory and the analysis of influencing factors on practising outsidethe hospital, this article suggests that it is better to increase the support and regulationof primary hospitals and private hospitals and deep our public institution reform. Inaddition, it is necessary to strengthen the professional associations of clinicalmedicine which should be the center of doctor multi-sites practice and establish themedical responsibility insurance.