Exploration of the driving mechanisms for the downward flow of high-quality medical resources in loose medical alliances:A qualitative comparative analysis from the perspective of Micro-cooperation theory
10.3969/j.issn.1674-2982.2024.08.007
- VernacularTitle:松散型医联体优质医疗资源下沉驱动机制探究
- Author:
Jun CHEN
1
;
Jia-Miao NIU
;
Ze-Yu YI
;
Hui DUAN
Author Information
1. 北京大学人民医院 北京 100044
- Keywords:
Loose medical alliance;
Medical cooperation;
Relationship commitment;
Physician behavior;
Fuzzy set qualitative comparative analysis(fsQCA)
- From:
Chinese Journal of Health Policy
2024;17(8):50-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore and stimulate the pathway mechanism for doctors from core hospitals,which are the high-quality medical resources in loose medical alliances,to sink to the grassroots level on their own initiative and continue to participate in the co-operation,so as to provide useful references for improving the effectiveness of cooperation within medical alliances.Methods:The fuzzy set Qualitative Comparative Analysis(fsQCA)method was used to investigate 205 doctors in the core hospitals of a loose medical alliance in District X of City B.This investigation was grounded in relationship commitment theory,motivation theory,social exchange theory,and cooperation reinforcement theory.Results:The level of relationship commitment of doctors in the core hospitals to proactively participate in cooperation was influenced by multiple factors,including doctors'perception of job significance,opportunity cost perception,organizational support,and teamwork experience.This resulted in the formation of three concurrent driving mechanism pathways:merger-driven effect,experience-enhancing effect,and altruistic trigger effect.Among these factors,the perception of work significance was a necessary condition,and cooperative experience played an important role in doctors'continuous participation.Conclusion:The level of relational commitment of doctors to participate in cooperative efforts is driven by a combination of various factors,with different incentive mechanisms exhibiting heterogeneity within loose medical alliances.Designing appropriate incentive and support strategies tailored to specific contexts can effectively drive the proactive downward flow of high-quality medical resources from core hospitals within loose medical alliances.
