患者参与对远程医疗服务创新绩效影响研究

发布时间：2018-03-04 19:35

本文选题：患者参与　切入点：远程医疗服务创新绩效　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：随着社会主义现代化的不断提高,居民生活水平的不断提升,温饱问题已不是居民关注的首要问题,居民更多关注的是医疗卫生等健康问题,而在就医困难的偏远地区,医疗健康问题是基层人民投入最多、最迫切需要得到解决的问题。但是,我国医疗资源分布的现状是优质医疗资源多集中于大城市的大医院中,而农村、城镇地区却非常稀缺,这导致了大医院床位不足而小医院门可罗雀的窘境。对于医院来说,解决该问题的办法是要积极提高医疗人员的医疗水平,提高医护人员的服务水平,简化就医流程,只有小医院能够留住当地病症较轻的患者,才能让大医院能够充分发挥资源优势救治那些重症患者;而政府要做好政策、资源合理引导的工作,即要优化配置医疗资源,积极实现分级诊疗,同时又要降低患者的医护成本。在“十二五”规划中明确指出,将远程医疗信息平台建设纳入到卫生信息化工程中,并由卫生部拨付专款建设中西部远程医疗试点,同时各级医院及地方政府也建立了远程医疗系统。远程医疗系统的建设正在如火如荼的开展进行中。在看到远程医疗迅猛发展的同时,也要关注患者的感受,远程医疗服务的好坏是由患者来评价的,而患者参与的行为则可以直接影响远程医疗服务的发展,从而影响远程医疗服务创新绩效。首先,本文对相关国内外研究成果进行了文献综述,介绍了服务创新理论、组织学习理论和知识管理理论的相关概念,在文献综述的基础上,提出本文研究观点:由于远程医疗在国内处于发展阶段,学者们的研究仅限于定性分析,缺乏对远程医疗服务创新绩效的定量研究,缺乏对患者参与远程医疗服务创新的研究,因此,本文提出患者参与远程医疗服务创新的动机、方式以及参与的结果。为下文分析患者参与远程医疗服务创新机制分析奠定理论基础。其次,本文对患者参与远程医疗服务创新的机制进行了理论分析,将远程医疗服务创新的模式界定为四个维度,即新服务概念、新顾客界面、新服务传递系统和技术;从认知需求、个人整合需求、社会整合需求、情感需求和利益需求等五方面需求分析患者参与的动机,为患者参与的可能性进行理论分析;然后将患者参与方式分为三种,即信息提供、合作生产及人际互动;理论分析了知识共享、组织学习在患者参与远程医疗服务创新的中介机制。为下文构建理论模型,提出研究假设打下基础。最后,构建了患者参与对远程医疗服务创新绩效影响的结构方程模型并提出研究假设,通过实证研究方法获取有效数据并对模型和假设进行实证检验。研究结果显示知识共享在患者参与和远程医疗服务创新绩效之间发挥着中介作用,以及组织学习在患者参与和知识共享间起到中介作用,揭示患者参与对远程医疗服务创新绩效的影响机理及其作用机制。本研究验证了患者参与通过组织学习、知识共享的中介作用,影响远程医疗服务创新绩效的路径及作用机制,也对现有的远程医疗服务创新研究进行了补充。
[Abstract]:With the continuous improvement of socialist modernization, people's living standard rising, the primary concern is not the problem of food and clothing of the residents, the residents are more concerned about health and other health problems, and in the remote area medical difficulties, health problems is the grassroots people into the largest and most urgent need to solve the problem. However, the current situation of medical the distribution of resources in our country is the high-quality medical resources are more concentrated in the big city hospital, while in rural areas, urban areas are scarce, this leads to a shortage of hospital beds and small hospitals in a deserted house dilemma. For the hospital, the solution to the problem is to actively improve the medical personnel's health care, to improve medical staff the service level, simplify the medical treatment process, only a small hospital to keep local symptoms in patients with mild, can let the hospital to give full play to the resource advantages of treatment Those patients with severe; and the government should make policy resources, reasonable guide work is to optimize the allocation of medical resources, actively implement hierarchical diagnosis and treatment, but also reduce the medical cost of patients. Clearly pointed out that in the "12th Five-Year" plan, the construction of remote medical information platform into the health information project, and appropriated funds by the Ministry of health the construction of the Midwest telemedicine pilot, at all levels of hospitals and the local government has also established a remote medical system. The construction of telemedicine system is being carried out like a raging fire. In that remote medical rapid development at the same time, but also should pay attention to the feelings of patients, remote medical service quality is evaluated by the patients, and patient participation behavior you can directly influence the development of telemedicine services, thus affecting the service innovation performance. In this paper, firstly, remote medical treatment, the research achievements on relevant domestic and foreign The literature review, introduces the theory of service innovation, organization related concepts of learning theory and knowledge management theory, on the basis of literature review, this study proposed viewpoint: due to remote medical treatment at the stage of development in China, the scholars limited to qualitative analysis, lack of quantitative research on telemedicine service innovation performance, the lack of study on patients participating in service innovation of telemedicine so this patients involved in remote medical service innovation motivation, and participate in the results. Patients involved in remote medical service innovation mechanism lays the theoretical foundation for the following analysis. Secondly this paper analysis, the mechanism of patients involved in remote medical service innovation was analyzed, the service the innovation of telemedicine is defined as four dimensions, namely the new service concept, new customer interface, new service delivery systems and technology; from the cognitive demand, The integration of individual needs, social integration needs five aspects of emotional needs and interests requirement analysis of patient participation motivation, theoretical analysis for the possibility of patient participation; and patient participation is divided into three kinds, namely information, cooperative production and interpersonal interaction; theoretical analysis of knowledge sharing, organizational learning in the intermediary mechanism of patients participate in service innovation in telemedicine. Construct a theoretical model for the following hypotheses, to lay the foundation. Finally, construct the structural equation of remote medical service innovation performance in patients with the model and proposes research hypotheses. Effective data acquisition through empirical research methods and empirical test of the model and hypothesis. The results show that the knowledge sharing play a mediating role between the patients involved in telemedicine and service innovation performance, and organizational learning and knowledge sharing in patients in between To reveal the mechanism of intermediary role, patient participation impact on telemedicine service innovation performance and its mechanism. This study validated patient participation through organizational learning, the role of knowledge sharing, impact path and mechanism of remote medical service innovation performance, but also gives a supplement to the existing research on the service innovation of telemedicine.

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R-05

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