Cui Chengsen, Lv Bo, Meng Kai
School of Public Health, Capital Medical University, Beijing, People's Republic of China.
China Center for Health Development Studies, Peking University, Beijing, People's Republic of China.
Risk Manag Healthc Policy. 2023 Sep 27;16:1969-1983. doi: 10.2147/RMHP.S425782. eCollection 2023.
Community health centers (CHCs) are an important part of the healthcare system worldwide. Based on the dual process model of organizational capabilities, this study explores the relationship between organizational capabilities and the organizational performance of CHCs, as well as the role played by the medical alliance implementation effect.
In this study, whole-group sampling was used to extract CHCs. All 135 CHCs in 8 of 16 districts of Beijing were selected as subjects. The organizational capabilities of the CHCs and the medical alliance implementation effect were evaluated using a questionnaire survey of 1957 managers and 3622 medical staff, respectively. A pathway analysis of the mediating role of the organizational capabilities of CHCs and the moderating role of the medical alliance implementation effect was conducted using Mplus 8.0.
The development capabilities had a positive impact on basic capabilities ( = 0.878, < 0.001), and core capabilities ( = 0.952, < 0.001), but had no direct impact on organizational performance. Basic capabilities positively affected organizational performance ( = 1.163, < 0.001), and core capabilities negatively affected organizational performance ( =- 0.886, = 0.004). Both basic capabilities ( =1.022, < 0.001) and core capabilities ( =- 0.843, = 0.005) played a mediating role in the relationship between development capabilities and organizational performance. The moderating role of the medical alliance implementation effect was not significant.
This study found that strengthening the organizational capabilities of CHCs can effectively improve their performance, with the development of basic capabilities being a primary concern. The medical alliance implementation effect has not had a significant impact on organizational performance, and the cooperation between CHCs and high-level hospitals should be further promoted to give full play to the medical alliance's role and improve the organizational performance of CHCs.
社区卫生中心（CHCs）是全球医疗体系的重要组成部分。基于组织能力的双过程模型，本研究探讨社区卫生中心的组织能力与组织绩效之间的关系，以及医疗联盟实施效果所起的作用。
本研究采用整群抽样法抽取社区卫生中心。选取北京市16个区中8个区的全部135家社区卫生中心作为研究对象。分别通过对1957名管理人员和3622名医务人员进行问卷调查，评估社区卫生中心的组织能力和医疗联盟实施效果。使用Mplus 8.0对社区卫生中心组织能力的中介作用和医疗联盟实施效果的调节作用进行路径分析。
发展能力对基础能力有正向影响（β = 0.878，p < 0.001），对核心能力也有正向影响（β = 0.952，p < 0.001），但对组织绩效没有直接影响。基础能力对组织绩效有正向影响（β = 1.163，p < 0.001），核心能力对组织绩效有负向影响（β = - 0.886，p = 0.004）。基础能力（β = 1.022，p < 0.001）和核心能力（β = - 0.843，p = 0.005）在发展能力与组织绩效的关系中均起中介作用。医疗联盟实施效果的调节作用不显著。
本研究发现，加强社区卫生中心的组织能力可有效提高其绩效，其中基础能力的发展是首要关注点。医疗联盟实施效果对组织绩效未产生显著影响，应进一步推动社区卫生中心与高水平医院的合作，以充分发挥医疗联盟的作用，提高社区卫生中心的组织绩效。
