Influencing factors and mechanism of physicians' strategic behavior under the DRG payment system.
10.11817/j.issn.1672-7347.2024.240593
- Author:
Aijing LUO
1
,
2
;
Zijian WANG
3
;
Fen JIANG
3
,
4
;
Weifu CHANG
3
,
5
Author Information
1. Clinical Research Center for Cardiovascular Intelligent Healthcare in Hunan Province, Second Xiangya Hospital, Central South University, Changsha
2. luoaj@csu.edu.cn.
3. Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha
4. 220225@csu.edu.cn.
5. 574224075@qq.com.
- Publication Type:Journal Article
- Keywords:
Theory of Planned Behavior;
diagnosis-related groups;
mechanism;
payment system;
strategic behavior
- MeSH:
Humans;
Physicians/psychology*;
Surveys and Questionnaires;
Attitude of Health Personnel;
Diagnosis-Related Groups/economics*;
Intention;
Female;
Male;
Adult
- From:
Journal of Central South University(Medical Sciences)
2024;49(11):1828-1839
- CountryChina
- Language:English
-
Abstract:
OBJECTIVES:Reforming medical insurance payment methods is a key part of deepening the healthcare system reform. Understanding the influencing factors and underlying mechanisms of physicians' strategic behaviors under the diagnosis-related groups (DRG) payment system is crucial for reducing medical resource waste and improving the efficiency of health insurance fund utilization.
METHODS:Based on the Theory of Planned Behavior, this study used grounded theory to construct a questionnaire encompassing belief, behavioral attitude, subjective norm, perceived behavioral control, behavioral intention, and behavior measurement items. Structural equation modeling was then used for empirical analysis.
RESULTS:Physicians' behavioral intention had the most significant impact on their strategic behavior (β=0.606, P<0.001). Physician's attitude toward strategic behavior (β=-0.159, P<0.01), subjective norm (β=-0.093, P<0.05), and perceived behavioral control (β=-0.120, P<0.05) were major influencing factors of behavioral intention. Physicians' behavioral beliefs, normative beliefs, and control beliefs were significantly correlated with behavioral attitude (β=0.554, P<0.001), subjective norm (β=0.383, P<0.001), and perceived behavioral control (β=0.274, P<0.001), respectively.
CONCLUSIONS:Behavioral intention is the primary predictor driving physicians to engage in strategic behavior. Attitudes toward the behavior, subjective norms, and perceived behavioral control all significantly affect physicians' behavioral intentions.
