Research On The Adoption And Diffusion Of Medical Consortia Based On Survival Analysis

At present,China's medical service industry is at the intersection of tradition and transformational innovation.The traditional medical treatment model and health service system are insufficient to meet the growing demand for high-quality medical care for the people.It's necessary to explore new medical service models to solve the current medical service dilemma.The proposal and construction of the medical consortium(referred to as "medical association")is an effective measure to integrate and rationally allocate medical resources.The April 2017 document "Guiding Opinions on Promoting the Construction and Development of Medical Consortiums" clarifies the standards for the construction of medical associations and provides policy guidance for the formation of medical cooperation networksHowever,the implementation of the medical association and the grading diagnosis and treatment mechanism in various provinces in China is slow and difficult.There are many problems between hospitals,government and hospitals.According to the theory of social influence,the degree of influence of environmental factors on organizational or individual adoption behavior is much greater than the influence of own factors.The hospital is affected by many factors in the process of choosing to join the medical association.There are organizational,environmental factors,and some people and policy factors.Therefore,based on survival analysis and innovation diffusion theory,this paper analyzes the influencing factors of hospitals in the process of adopting medical associations,and puts forward corresponding suggestions for it.In the context of China's continuous promotion of the construction of medical associations,the article uses the theory of innovation diffusion and survival analysis to study the behavior of hospitals in the medical association,and puts forward 11 research hypotheses,including hospital outpatient volume,hospital grade,and information,the hospital degree,hospital time,hospital size,hospital time × hospital size,geographical conditions and distance as influencing factors,the Cox regression analysis model was constructed,and the behavior of hospitals joining the medical association was analyzed by empirical method.The research design is as follows: Firstly,the relevant literature is combined with the geographical location characteristics of Yunnan Province to extract the influencing factors,and the questionnaire is designed to select 218 hospitals in Yunnan Province for investigation;secondly,the basic information of the hospital and the explanatory variables are analyzed statistically;Third,using the expectation-prediction curve and the Schoenfeld residual method,the PH hypothesis test for each variable analyzes whether the variable meets the conditions of the Cox model.Fourth,the Cox layered model is used for the variable that does not meet the PH hypothesis.Other factors used semi-parametric Cox regression analysis.Finally,the Cox regression results under different conditions were analyzed to verify whether the proposed 11 hypotheses were established and the medical association adoption and diffusion analysis were performed.The results showed that the outpatient volume,hospitalization time and distance were positive factors,and the geographical conditions were significant obstacles.The size of the hospital and the degree of informatization showed that the hospitals adopted the medical association in the Cox regression of organizational factors.There was no significant effect on joining the medical union.Diffusion analysis shows that the trend of hospitals joining the medical union has not yet reached its peak,indicating that the medical association is still in the exploratory stage.Based on the data,the efficiency of collaboration between hospitals in the medical association is not high,and the grading diagnosis and treatment mechanism has not been effectively implemented.Further research is needed on the cooperation and development of the medical association.Finally,based on the results of empirical and diffusion analysis,summarize the influencing factors of hospitals joining the medical association,provide rationalization suggestions for the member units and competent departments of the medical association,and accelerate the construction of the grading diagnosis and treatment mechanism in Yunnan Province.