Wang Wenxing, van Wijngaarden Jeroen, Buljac-Samardžić Martina, van de Klundert Joris
Health Services Management & Organization, Erasmus School of Health Policy & Management, Rotterdam, Netherlands.
School of Business, Universidad Adolfo Ibanez, Santiago de Chile, Chile.
Front Health Serv. 2025 Jul 18;5:1401641. doi: 10.3389/frhs.2025.1401641. eCollection 2025.
In pursuit of the ambitious and large scale 2009 national health reform objectives, China has turned to the introduction and implementation of foreign best practices in health service delivery. While it is well known that cultural differences may significantly impact the adoption and implementation of innovations, there is little specific knowledge on how these impact foreign health service innovations adopted in China. Our aim is therefore to identify which cultural norms and values affect the adoption and implementation of foreign innovations in health service delivery in the Chinese context and how.
We interviewed a variety of respondents (government officials, directors, doctors, consultants, researchers) involved in the adoption and implementation of foreign health service delivery organizations from China ( = 10) and from The Netherlands ( = 9), with which China has built long-standing cooperation on exchanging innovations in health service delivery. A semi-structured interview guide was used. The interviews were transcribed verbatim, translated (Chinese into English) and coded, using both thematic and open codes.
Identified values and norms related to health and care, health services and professionals, and organizational dynamics respectively. Some act as potential barriers to the adoption of innovations (e.g., the body must be treated with respect), some play a facilitating role (e.g., eagerness to learn from other cultures), and some can be either a facilitator or a barrier depending on the circumstances or the views of our respondents (e.g., filial piety, longevity is valued over quality of life).
Innovations in primary and elderly care that are nurse-led and focus on new service concepts emphasizing personalized care, experience cultural barriers in China. Meanwhile more structural and technical innovations especially in a hospital setting are strongly facilitated by Chinese cultural characteristics. While the national culture has a significant impact on foreign innovations in China, the interactions of those innovations with the local cultural context at meso- and micro- levels additionally plays an important role.
为实现2009年宏伟且大规模的国家卫生改革目标，中国已着手引进并实施国外卫生服务提供方面的最佳实践。虽然众所周知文化差异可能会显著影响创新的采用和实施，但对于这些差异如何影响在中国采用的国外卫生服务创新，却知之甚少。因此，我们的目的是确定哪些文化规范和价值观会影响在中国背景下国外卫生服务提供创新的采用和实施，以及如何产生影响。
我们采访了参与采用和实施国外卫生服务提供组织的各类受访者（政府官员、主任、医生、顾问、研究人员），这些组织来自中国（n = 10）和荷兰（n = 9），中国与荷兰在卫生服务提供创新交流方面建立了长期合作关系。使用了半结构化访谈指南。访谈内容逐字记录、翻译（中文译成英文）并编码，同时使用主题编码和开放编码。
分别确定了与健康和护理、卫生服务与专业人员以及组织动态相关的价值观和规范。有些价值观和规范对创新的采用构成潜在障碍（例如，必须尊重身体），有些则起到促进作用（例如，渴望向其他文化学习），还有一些根据情况或受访者的观点既可以是促进因素也可以是障碍（例如，孝道、长寿比生活质量更受重视）。
以护士为主导、注重强调个性化护理的新服务理念的初级和老年护理创新在中国面临文化障碍。与此同时，特别是在医院环境中的更多结构性和技术性创新受到中国文化特征的有力推动。虽然民族文化对中国引进的国外创新有重大影响，但这些创新在中观和微观层面与当地文化背景的相互作用也起着重要作用。
