公立医院组织文化对综合绩效的影响研究

发布时间：2018-06-02 12:36

本文选题：公立医院 + 医院组织文化　；参考：《南京中医药大学》2017年硕士论文

【摘要】：我国非常重视文化领域的大发展、大繁荣,作为社会主义文化的一个重要分支,医院文化已不只是一个概念存在,而是现代医院管理的新趋势。目前公立医院改革已进入攻坚克难的阶段,如何在遵从新医改整体目标基础上实现自身综合绩效的提高和可持续发展,如何正确发挥文化的助推作用以促进改革进程,是迫切需要解决的问题。医疗卫生领域对文化与绩效关系的研究不多,且大部分的研究从社会效益或经济效益单方面着手,进行综合绩效研究的很少。本研究旨在剖析公立医院组织文化对综合绩效的影响,探究医院文化影响综合绩效的具体路径,并提出提升公立医院综合绩效的医院文化建设措施,为医改提供理论支撑。研究成果将进一步拓宽医院文化及综合绩效的立论观点及研究视角,为各地公立医院实际推行文化建设及医药卫生体制改革提供参照,进一步推动新医改进程。基于上述研究目的,本次公立医院组织文化对综合绩效的影响研究包括以下几个方面:(1)文献综述,对公立医院组织文化及综合绩效相关研究进行系统整理。(2)理论分析,从结构上理清公立医院文化如何影响综合绩效,以基因—文化协同理论、委托代理理论、利益相关者理论为基础,并结合文献综述,提出公立医院组织文化对综合绩效影响的模型与假设。(3)实证研究,通过问卷调查法及SEM(结构方程模型)对所提假设进行验证。调查样本为省内南京、无锡、苏州、泰州、南通等地具备一定文化规模的二级及以上公立医院14所;调查对象包括公立医院的医务人员、管理人员、政府卫生部门的管理人员,高校相关专家等,共获得有效问卷289份;统计工具为SPSS19.0软件(检验数据信度、效度)和Lisrel8.70软件(构建结构方程模型)。(4)结论建议,对研究结果进行讨论,并以提升公立医院综合绩效为目的,提出医院文化建设措施。经过研究总结,表明公立医院组织文化中凝聚协调文化特质、激励约束文化特质、外部适应文化特质均对综合绩效产生影响,即科学先进的医院文化建设能促进公立医院综合绩效的提升。由此提出提升公立医院综合绩效的医院文化建设的建议,即发挥公立医院凝聚协调的文化特质,履行社会责任,树立正确价值观、提倡团队合作,促进医院内部协调,确保综合绩效的实现;突出公立医院外部适应的文化特质,重视学习与创新、以人为本、弘扬医学人文精神,共建和谐的文化环境;重视公立医院激励约束的文化特质,树立竞争、持续发展意识,加强人才队伍建设、培养医务人员职业精神,规范管理制度、适当下放权力,保持发展活力;并提出提升公立医院组织文化建设战略地位,发挥文化的积极作用,推进公立医院改革。
[Abstract]:China attaches great importance to the great development and prosperity of the cultural field. As an important branch of socialist culture, hospital culture is not only a concept of existence, but also a new trend of modern hospital management. At present, the reform of public hospitals has entered a difficult stage. How to achieve the improvement and sustainable development of their own comprehensive performance on the basis of complying with the overall goal of the new medical reform, and how to give full play to the role of culture in promoting the reform process. It is an urgent problem that needs to be solved. There are few researches on the relationship between culture and performance in the field of medical and health, and most of the studies are carried out unilaterally from the social or economic benefits. The purpose of this study is to analyze the impact of public hospital organizational culture on comprehensive performance, to explore the specific path of hospital culture impact on comprehensive performance, and to put forward the measures of hospital culture construction to improve the comprehensive performance of public hospitals, and to provide theoretical support for medical reform. The research results will further broaden the viewpoint and perspective of hospital culture and comprehensive performance, provide references for the actual implementation of cultural construction and medical and health system reform in local public hospitals, and further promote the process of new medical reform. For the purpose of the above research, this research includes the following aspects: 1) Literature review, and a systematic analysis of the related research on organizational culture and comprehensive performance of public hospitals. Based on the theory of gene-culture synergy, principal-agent theory, stakeholder theory, and literature review, this paper clarifies how public hospital culture affects comprehensive performance from the perspective of structure. An empirical study on the influence of organizational culture in public hospitals on comprehensive performance is presented. The hypothesis is verified by questionnaire survey and SEM (structural equation Model). The survey samples were 14 public hospitals of a certain cultural scale in Nanjing, Wuxi, Suzhou, Taizhou, Nantong and other places in the province. The subjects included medical personnel, management personnel, and administrative personnel of government health departments in public hospitals. A total of 289 valid questionnaires were obtained from relevant experts in colleges and universities. The statistical tools were SPSS19.0 software (test data reliability, validity) and Lisrel8.70 software (construction of structural equation model, etc.). The results of the study were discussed. In order to improve the comprehensive performance of public hospitals, the measures of hospital culture construction are put forward. Through the research and summary, it is shown that the combination and coordination of cultural characteristics in the organizational culture of public hospitals, the stimulation and restraint of cultural characteristics, and the cultural characteristics of external adaptation all have an impact on the comprehensive performance. That is, the construction of scientific and advanced hospital culture can promote the comprehensive performance of public hospitals. Therefore, some suggestions are put forward to improve the comprehensive performance of public hospitals, that is, to bring into play the cultural characteristics of public hospitals' cohesion and coordination, to fulfill their social responsibilities, to establish correct values, to promote teamwork, and to promote internal coordination in hospitals. To ensure the realization of comprehensive performance, highlight the cultural characteristics of external adaptation of public hospitals, attach importance to learning and innovation, people-oriented, carry forward the medical humanistic spirit, build a harmonious cultural environment, attach importance to the cultural characteristics of public hospitals, Set up the competition, keep developing consciousness, strengthen the construction of talents, train the professional spirit of medical personnel, standardize the management system, appropriately devolve the power, maintain the vitality of development, and raise the strategic position of organizational culture construction in public hospitals. Give play to the positive role of culture and promote the reform of public hospitals.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.3

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