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基层医疗团队效能的形成机制:定性比较分析研究。

The formation mechanism of primary health care team effectiveness : a qualitative comparative analysis research.

机构信息

Department of Health Management and Policy, School of Public Health, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Hangzhou, 311121, China.

Department of Quality Management, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, 310016, China.

出版信息

BMC Prim Care. 2024 Jan 29;25(1):45. doi: 10.1186/s12875-024-02278-8.

Abstract

BACKGROUND

Team-based care is an essential part of primary health care (PHC), and its team service delivery process is a systematic one involving multiple and complex influences. Research on the formation mechanism can help improve the effectiveness of primary health care teams (PHCTs).

METHODS

First, based on the Donabedian model, we explored the theoretical framework of a PHC team's effectiveness formation mechanism. Semi-structured interviews were conducted with 23primary health care team members in Hangzhou, Zhejiang Province, China. A total of seven factors were then included as conditional variables using the crisp set qualitative comparative analysis (csQCA) to explore the complex influences between them and the outcome variable through univariate necessity analysis and path configuration analysis.

RESULTS

Univariate necessity analysis showed that only "Clear Goals" in the structural dimension were necessary for team effectiveness perception. Six pathways to good primary health care team perception of effectiveness were identified. Two of these paths were more typical.

CONCLUSION

"Clear Goals" was the core variable that should be emphasized when exploring the mechanism of PHCT formation. The results suggest that human resources in the management team should be rationally allocated, goal-oriented, and given good attention. Future studies should explore complex combinations of PHCT factors to improve the effectiveness of PHCTs.

摘要

背景

团队式医疗是基层医疗保健(PHC)的重要组成部分,其团队服务提供过程是一个系统过程,涉及多个复杂的影响因素。对形成机制的研究有助于提高基层医疗保健团队(PHCT)的效率。

方法

首先,我们基于 Donabedian 模型,探讨了 PHC 团队有效性形成机制的理论框架。对来自中国浙江省杭州市的 23 名基层医疗保健团队成员进行了半结构化访谈。然后,使用明晰集定性比较分析(csQCA),共纳入七个条件变量,通过单变量必要性分析和路径配置分析来探讨它们与结果变量之间的复杂影响。

结果

单变量必要性分析表明,只有结构维度中的“明确目标”对团队效能感知是必要的。确定了六种良好的基层医疗保健团队有效性感知途径。其中两条途径更具典型性。

结论

“明确目标”是探索 PHCT 形成机制时应重点强调的核心变量。研究结果表明,应合理配置管理团队中的人力资源,目标导向,并给予充分关注。未来的研究应探讨 PHCT 因素的复杂组合,以提高 PHCT 的效率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74c2/10823627/01a3242cc447/12875_2024_2278_Fig1_HTML.jpg

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