健康发展与政策研究2024，Vol.27Issue(6)：505-510,6.DOI:10.12458/HDPR.202409021
整合型医疗卫生服务体系交易费用的供方认知分析
Analysis of provider perceptions of transaction costs in integrated delivery systems
摘要
Abstract
Objective To assess the perception of transaction costs on the provider side within integrated delivery systems(IDS)and propose strategies to enhance understanding,thereby increasing the motivation to achieve policy goals within IDS.Methods Guided by the Williamson-Steven Cheung analysis paradigm,this study decomposed the transaction costs of the integrated health service system into planning and decision costs,specific investment costs,operational collaboration costs,and supervision costs.J District in Z City of Henan Province,N County of Shandong Province,and D Prefecture of Qinghai Province were selected as the research objects using typical sampling method.Questionnaire surveys were administered to collect demographic and relevant information from provider-side staff.A cognitive assessment scale was employed to measure their perception of IDS transaction costs.Propensity score matching(PSM)was utilized to verify differences in cognitive abilities across different provider-ide groups,and multiple linear regression models were used to analyze the factors influencing cognitive ability.Results A total of 936 staffmembers participated in the survey.The average score on the transaction cost cognitive scale was 12.59±3.22.Furthermore,53.42%of respondents perceived planning and decision-making costs as high or very high,75.11%rated specific investment costs as average or below,92.52%considered operational collaboration costs to be average or above,and 77.14%evaluated supervision costs as average or below.Before and after PSM,cognitive ability scores were higher among staffin leading hospitals than those in member units.Factors such as age,educational level,organization nature,and position significantly influenced the provider side staff's perception of transaction costs(all P＜0.05).Conclusions Staffon the provider side generally perceive transaction costs in IDS to be moderate,particularly concerning planning and decision-making,and operational collaboration costs.Perceptions of transaction costs vary among different provider side groups in IDS,influenced by factors such as age,ethnicity,educational level,working years,organization type,and position.Future efforts should focus on raising awareness of the hidden and pervasive nature of transaction costs and establishing a cost-saving institutional framework to improve provider side perceptions and boost confidence in achieving policy goals within IDS.关键词
整合型医疗卫生服务体系/交易费用/供方认知/政策实施Key words
integrated delivery system/transaction cost/provider perception/policy implementation分类
医药卫生引用本文复制引用
苗豫东,张敬宝,叶贝珠,付硕..整合型医疗卫生服务体系交易费用的供方认知分析[J].健康发展与政策研究,2024,27(6):505-510,6.基金项目
国家社会科学基金一般项目(21BGL222) （21BGL222）
