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从结构网络角度看家庭医生团队流程对慢性病管理绩效的影响。

The effect of family physician team processes on chronic disease management performance from a structural network perspective.

机构信息

Nanyang Central Hospital, Nanyang, Henan, 473000, China.

School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.

出版信息

BMC Prim Care. 2024 Aug 10;25(1):292. doi: 10.1186/s12875-024-02550-x.

Abstract

OBJECTIVE

The family physician team has become the core carrier for delivery primary health care in China. This study aimed to measure the effect of the network structural characteristics of family physician team processes on health performance. Strategic recommendations for optimizing the family physician team processes with a view to improving performance were presented.

METHODS

A cross-sectional survey was conducted from October to December 2021 in Qianjiang in Hubei Province and Changsha in Hunan Province. Task performance, contextual performance, social networks, and sociodemographic characteristics were collected. Social network analysis was conducted to calculate density and centralization, then hierarchical linear regression analysis was employed to explore the relationship between the network structural characteristics of family physician team processes and performance.

RESULTS

In total, 88 family physician teams attended in this investigation. The transition processes of family physician team showed a distinctive low density (0.272 ± 0.112), high centralization (0.866 ± 0.197) network structure. For family physician team, the density of action processes significantly and positively affected task performance (B = 0.600, P < 0.05); the centralization of action processes positively affected task performance (B = 0.604, P < 0.01); the density of action processes positively affected contextual performance (B = 0.545, P < 0.01); the density of interpersonal processes significantly and positively affected contextual performance (B = 0.326, P < 0.05).

CONCLUSION

The network density and centralization of family physician team processes have positive effects on chronic disease management performance. The results from this study help to enhance our conceptual understanding of social network and its implications for team-dynamics. Optimizing family physician team processes is an effective way to strengthen the construction of family physician team and promote the quality and efficiency of family physician-contracted service. It is recommended to strengthen the management of team processes, enhance the internal collaboration mechanism, and optimize the centralized network structure of family physician team.

摘要

目的

家庭医生团队已成为中国提供初级卫生保健的核心载体。本研究旨在衡量家庭医生团队流程的网络结构特征对健康绩效的影响。提出了优化家庭医生团队流程的战略建议,以期提高绩效。

方法

2021 年 10 月至 12 月在湖北省潜江市和湖南省长沙市进行了一项横断面调查。收集了任务绩效、情境绩效、社会网络和社会人口学特征。进行社会网络分析以计算密度和集中化程度,然后采用分层线性回归分析来探讨家庭医生团队流程的网络结构特征与绩效之间的关系。

结果

共有 88 个家庭医生团队参与了此次调查。家庭医生团队的过渡过程呈现出明显的低密度(0.272±0.112)、高集中化(0.866±0.197)网络结构。对于家庭医生团队,行动过程的密度显著正向影响任务绩效(B=0.600,P<0.05);行动过程的集中化正向影响任务绩效(B=0.604,P<0.01);行动过程的密度正向影响情境绩效(B=0.545,P<0.01);人际过程的密度显著正向影响情境绩效(B=0.326,P<0.05)。

结论

家庭医生团队流程的网络密度和集中化对慢性病管理绩效有积极影响。本研究的结果有助于增强我们对社会网络及其对团队动态影响的概念理解。优化家庭医生团队流程是加强家庭医生团队建设、提高家庭医生签约服务质量和效率的有效途径。建议加强团队流程管理,增强内部协作机制,优化家庭医生团队的集中网络结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d444/11316317/5d27554db839/12875_2024_2550_Fig1_HTML.jpg

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