Research On The Influencing Factors Of Public’s Cognition And Willingness To Participation In Public Hospitals Social Evaluation

Objectives:Using social evaluation and governance,knowledge attitude and practice(KAP),planned behavior(TPB) and a ladder of citizen participation theory, combination of qualitative and quantitative research methods, scientific discriminate the concepts related to the public, defining the connotation of the public participation in the social evaluation of public hospitals;through the scene investigation to grasp the level of cognition and willingness of public participate in social evaluation of public hospital on the basis of self-designed questionnaire,analysis the main influencing factors and the relationship between logic and mechanism of action, to activate and provide the basis for the development of public participation in public hospitals social evaluation and governance paths and strategies.Methods:This study selected The No.l people’s hospital and the hospital of traditional Chinese medicine and around the area of a total of four in the two cities, the cities is Lianyun gang,Jiangsu Province,Hangzhou,Zhejiang Province where with the north-south cultural differences places located in the eastern,using occasional sampling method intercept 1075 citizens for questionnaire.Using Epidata3.1 software to establish a database,SPSS20.0,AMOS21.0 software for statistical analysis.Using Cronbach’s a coefficient test the reliability of the questionnaire, exploratory and confirmatory factor analysis test the validity of the questionnaire; reference satisfaction five level weighting method and general descriptive statistical analysis the level of cognition and willingness of public participate in social evaluation of public hospitals;rank sum test to compare the different sociodemographic characteristics of the public;multiple linear regression to analysis the influencing factors of the cognition and willingness; Spearman rank correlation, structural equation model method validation analysis the relationship,logic and mechanism of cognition,willingness and attitude,subjective norm and perceived behavioral control of the public participation in social evaluation based on the theory of planned behavior.Results:(1)The each dimension Cronbach’s a coefficients of questionnaire are above 0.890, and the questionnaire overall Cronbach’s a coefficients is 0.962, KMO is 0.952,P<0.001,and each items in the corresponding dimension of the total explained variance rate higher than 60%;(2)We investigated 1075 subjects,and 766 people (71.26%) were public by scientifically screened.The public in first ladder were 445 (41.39%), the second ladder were 144 (13.39%) and the third ladder were 177 (16.47%);(3)The object of investigation’s cognition rate of respondents was 63.83%,the rate of public hospital social responsibility, social evaluating subject and purpose, the right and responsibility of 15 cognitive items were 52.65%-64.41%.The pubilc’s cognition rate was 66.72%,and in first, second and third ladder were 64.55%,67.18% and 71.80%;(4)The willingness rate of subjects in participating with different ways was 70.70%. For public,it’s 73.43%, and in first, second and third ladder were 71.10%,73.73% and 79.03%.The willingness rate of public in participating with different evaluation contents was 70.44%. For public,it’s 73.10%, and in first, second and third ladder were 70.03%,74.08% and 80%;(5)The public’s cognition and willingness rate has a significant difference on different age, education, occupation,income,ladders(P<0.001).(6)Attitude, subjective norm and perceived behavior controlling based on the theory of planned behavior,the coefficient about the mode of evaluation are 0.494,-0.168 and 0.290.The coefficient about the content of evaluation are 0.520、-0.114 and 0.258.The coefficient of cognitive on attitude, subjective norm, perceived behavioral control are 0.520.0.420 and 0.302 (P<0.001). And the P value about the cognition of evaluation methods and content willingness is greater than 0.05. The indirect effect about attitude, subjective norm, perceived behavioral control are 0.257、-0.071、0.088 by further analyzing the effect of each variable. The indirect effect about content willingness were 0.270、-0.048、0.078; the r value between attitude and subjective norm is 0.514 (P<0.01), and the r value between attitude and perceived behavior control is 0.397 (P<0.01),The r value between subjective norm and perceived behavioral control is 0.603 (P<0.01).Conclusion:(1) The self-designed "The questionnaire of cognition and willingness of the public participation in social evaluation of public hospitals" has higher reliability and validity, and can be used for measuring the public to participate in the recognition and willingness level.(2)The subjects in sample urban who was participated in public affairs still on the first step by "information accept" characteristic;(3)The public behavior willingness on participating in public hospitals social evaluation is higher, but the cognitive level is lower, rationality participation and capacity needs to be strengthened and developed; (4)18 to 44 years of age, higher education, managers, professionals, professional and technical personnel, college students has higher levels of cognition and willingness to participate in public hospital social evaluation.(5) The public attitude and perceived behavior control of public participation in public hospitals have a direct positive effect on the willingness, subjective norms have a weak negative correlation on the willingness; The cognitive has a direct positive influence on attitude, subjective norm and perceived behavioral control,but not directly affected the willingness, mainly through attitude, perceived behavioral control indirect promotion effect on the willingness.So Attitude, subjective norm and perceived behavioral control has a positive correlation with each other.(6) Recommends that the government deepen the reform of the social management system of public hospitals, decentralization, establish the agency and social governance mechanism of public health affairs management, improve medical information disclosure, public participation and standardized construction. To guide public median propaganda and response to public in order to increasing public cognition, activate or strength the social public power for supervision and governance in public hospitals.Public hospitals should consciously accept social evaluation and supervision from the public governance or the industry self-discipline management, actively promote medical social workers, social observers and supervisor participate involved in the public construction.Social professional organizations nest to take advantage of its social third party and professional authority to set up a platform for technical guidance, training and communication, strengthen the rational cognition and participation ability;The Public media should make programs about public health policy or cognitive education to build a communication and interaction, publishing the authority results platform, to guide the public opinion direction and to timely response to social concern, to improve citizen’s general cognition level and participation capacity.The public should conscious enhancement the cognition capacity of the right to life and health and the government-run public hospital the supply of public health activities and participation, supervision, and access to effective change in attitude and perceived behavioral control improvements to increase the public participation behavior willing.