按病种分值付费改革背景下医务人员政策认知、感知价值对行为规范的影响
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南通大学公共卫生学院

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国家社科基金重大项目


Influence of medical staff's policy awareness and perceived value on diagnosis and treatment behavior in the context of the Diagnosis-Intervention Packet reform by disease component
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School of Public Health,Nantong University,Nantong 226019,China

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National social science foundation

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    摘要:

    为探索按病种分值付费(Diagnosis-Intervention Packet,DIP)改革后政策认知、感知价值对医务人员行为规范的影响,本研究于2023年10月-11月采用方便抽样的方法,对L市300名医务人员在DIP改革后政策认知、感知价值和行为规范进行问卷调查。采用PROCESS程序中的Model 4检验感知价值对政策认知和行为规范关系间的中介作用。结果表明医务人员的政策认知得分为(19.24±5.87)分,感知价值得分为(42.99±12.48)分,行为规范得分为(31.25±6.06)分。多因素线性回归分析结果表明,医务人员的政策认知(β=0.13, p<0.01)、感知价值(β=0.38 p<0.001)正向预测诊疗行为规范。中介效应检验表明感知价值在医务人员的政策认知水平和诊疗行为之间起到部分中介作用,中介效应占比为58.06%。因此,医务人员DIP改革政策认知得分越高,政策感知价值越高,从而进一步增加诊疗行为的规范。

    Abstract:

    To explore the effects of policy awareness and perceived value on medical staff's diagnosis and treatment behavior after the Diagnosis-Intervention Packet (DIP) reform, this study conducted a questionnaire survey of 300 medical staff in L City on policy awareness, perceived value, and diagnosis and treatment behavior after the DIP reform in October-November 2023 using convenience sampling. Multifactor linear regression and Bootstrap methods were used to test the mediating role of perceived value on the relationship between policy awareness and diagnosis and treatment behavior. The results showed that medical staff scored (19.24±5.87) for policy awareness, (42.99±12.48) for perceived value, and (31.25±6.06) for diagnosis and treatment behavior. The results of multifactor linear regression analysis showed that medical staff's policy awareness (β=0.13, p<0.01) and perceived value (β=0.38, p<0.001) positively predicted diagnosis and treatment behavior. In addition, Bootstrap results indicated that perceived value partially mediated the relationship between medical staff's level of policy awareness and diagnostic and treatment behaviors, with a mediating effect of 58.06%. Therefore, the higher the medical staff's DIP reform policy awareness score, the higher the perceived value of the policy, which further increases the norms of diagnosis and treatment behaviors.

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  • 收稿日期:2024-05-14
  • 最后修改日期:2024-07-01
  • 录用日期:2024-07-02
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