在DRG支付方式改革的背景下,分析影响医疗行为变化的因素:结构方程建模方法
Chen Jiang1, Dawei Qin2, JinPeng Zhang2
1School of Management, Shandong Second Medical University, Weifang, China.
Frontiers in public health
|September 29, 2025
概括
医疗保健工作者对诊断相关群体 (DRG) 支付改革的理解不如他们对政策的看法那么有影响. 积极的认知驱动所需的医疗行为,而负面的认知增加有害的做法,强调了需要面向价值的培训.
科学领域:
- 卫生政策 卫生政策
- 医疗保健管理的管理
- 行为经济学是一种行为经济学.
背景情况:
- 与诊断相关的群体 (DRG) 支付方式的实施代表了医疗保健融资的重大转变.
- 了解医疗保健工作者的看法和行为对于成功的DRG改革至关重要.
- 之前的研究还没有完全阐明政策理解,认知意识和行为变化之间的关系.
研究的目的:
- 评估医疗保健工作者对DRG支付改革政策的理解.
- 检查政策理解和认知意识对医学行为模式的影响.
- 确定推动行为适应中国DRG改革的因素.
主要方法:
- 在2023年11月至12月期间,在中国北部城市的医疗保健工作人员中进行了一项在线问卷调查.
- 该调查收集了有关人口统计,政策理解,政策认知和医疗行为的数据.
- 使用结构方程建模来分析这些变量之间的关系.
主要成果:
- 政策理解没有显著影响政策认知.
- 更高的政策理解与对积极医疗行为的负面影响和对负面医疗行为的积极影响有关.
- 积极的政策认知促进了积极的医疗行为,而负面的政策认知增加了负面的医疗行为.
结论:
- 响应DRG改革的行为变化主要是由认知评估驱动的,而不是仅仅是政策知识.
- 在不涉及认知方面的技术培训可能会在经济压力下无意中鼓励不良行为.
- 优化DRG改革需要专注于以价值为导向的培训,并实施强有力的审计机制,以减轻高风险行为.
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