可跨国比较的中国医院管理调查体系的构建研究
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摘要
为了解中国医院的管理水平以及国际定位,本研究团队根据国际上已广泛使用的世界管理调查方法论,研发了中国医院管理调查工具(Chinese hospital management survey,CHMS),包括20个管理实践的调查项目,涵盖四个主要管理维度:运营管理、绩效管理、目标管理和人才管理,形成了四维度、20项的医院管理模型。基于CHMS方法,在全国400多家有代表性的医院中抽取科室管理人员开展了调查研究,并对调查结果进行模型验证研究。结果显示,该模型卡方/自由度(CMIN/DF)为2.209,近似均方根误差(RMSEA)为0.039,表现出良好的模型拟合。其它拟合优度指数如GFI,IFI和CFI等均在0.9以上,都符合良好拟合模型的标准。本研究表明,CHMS已经在中国医院管理实践中得到验证,可作为有效的调查方法来测量和评价中国医院管理水平,并为中国医院管理水平的跨国比较提供通用研究平台。
To understand the management level and international positioning of Chinese hospitals,we developed a comprehensive survey instrument of chinese hospital management survey following the well-adapted methodology of world management survey which has been widely used internationally. The survey was conducted on 20 management practices covering four major management dimensions including operations management,performance management,target management and talent management respectively. Based on the CHMS structure and setting,the four-dimension and twenty-item management model was analyzed with construct validity test. From the test,the middle level managers were recruited from more than 400 chinese national representative hospitals. The results showed that the chi-square/degree of freedom( CMIN/DF) is 2. 209,and RMSEA( root mean square error approximate) is 0. 039,indicating a good model fitting. The further indications of model fit such as GFI,IFI and CFI were all above 0. 9 which is the typical benchmark for model acceptance. This study provides evidence for correspondence between conceptual and empirical hospital management and the insight of model fitting on the current data. The results conclude that CHMS has satisfied validation in Chinese hospital management practices,and can be used as an effective survey method to assess the level of Chinese hospital management and to provide a general platform for international comparison.
To understand the management level and international positioning of Chinese hospitals,we developed a comprehensive survey instrument of chinese hospital management survey following the well-adapted methodology of world management survey which has been widely used internationally. The survey was conducted on 20 management practices covering four major management dimensions including operations management,performance management,target management and talent management respectively. Based on the CHMS structure and setting,the four-dimension and twenty-item management model was analyzed with construct validity test. From the test,the middle level managers were recruited from more than 400 chinese national representative hospitals. The results showed that the chi-square/degree of freedom( CMIN/DF) is 2. 209,and RMSEA( root mean square error approximate) is 0. 039,indicating a good model fitting. The further indications of model fit such as GFI,IFI and CFI were all above 0. 9 which is the typical benchmark for model acceptance. This study provides evidence for correspondence between conceptual and empirical hospital management and the insight of model fitting on the current data. The results conclude that CHMS has satisfied validation in Chinese hospital management practices,and can be used as an effective survey method to assess the level of Chinese hospital management and to provide a general platform for international comparison.
引文
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[13]陈晔,甘雪琼,韩明林,等.我国医院质量管理现状——基于五省调研[J].中国卫生政策研究,2016,9(8):49-54.
[14]韩优莉,吴国安,李文超,等.北京市公立医院管理行为现状调查[J].中国医院管理,2013,33(2):13-15.
[15]Healthcare Survey Instrument,2009.http://mentsurvey.org/wp-content/images/2011/01/Healthcare_Survey_Instrument_20110110.pdf
[16]Williams L J,Vandenberg R J,Edwards J R.Structural Equation Modeling in Management Research:A Guide for Improved Analysis[J].Academy of Management Annals,2009,3(1):543-604.
[2]World Bank.China,World Bank and WHO Collaborate to Support‘Deep Water'Phase of health reforms,2015[EB/OL].[2017-02-26].http://www.worldbank.org/en/news/feature
[3]Bloom N,Reenen J V.Measuring and Explaining Management Practices across Firms and Countries[J].Quarterly Journal of Economics,2007,122(4):1351-1408.
[4]Bertrand M,Schoar A.Managing with Style:The Effect of Managers on Firm Policies[J].Quarterly Journal of Economics,2003,118(4):1169-1208.
[5]Locke R M,Qin F,Brause A.Does Monitoring Improve Labor Standards?Lessons from Nike[J].Social Science Electronic Publishing,2007,61(1):3-31.
[6]Mccormack J,Propper C,Smith S.Herding Cats?Management and University Performance[J].Economic Journal,2014,124(578):F534-F564.
[7]Bloom N,Propper C,Seiler S,et al.The Impact of Competition on Management Quality:Evidence from Public Hospitals[J].Social Science Electronic Publishing,2010,82(2):457-489.
[8]Bloom N,Reenen J V.Management Practices Across Firms and Countries[J].Social Science Electronic Publishing,2012,26(1):12-33.
[9]Mcconnell K J,Lindrooth R C,Wholey D R,et al.Management practices and the quality of care in cardiac units.[J].Jama Internal Medicine,2013,173(8):684-692.
[10]Mcconnell K J,Lindrooth R C,Wholey D R,et al.Modern Management Practices and Hospital Admissions.[J].Health Economics,2016,25(4):470-485.
[11]Allen P,Cao Q,Wang H.Public hospital autonomy in China in an internationalcontext[J].International Journal of Health Planning&Management,2014,29(2):141.
[12]汪志明,邱智渊,林建华.JCI评审与国内综合医院管理评估的比较研究[J].中国卫生质量管理,2008,15(6):20-22.
[13]陈晔,甘雪琼,韩明林,等.我国医院质量管理现状——基于五省调研[J].中国卫生政策研究,2016,9(8):49-54.
[14]韩优莉,吴国安,李文超,等.北京市公立医院管理行为现状调查[J].中国医院管理,2013,33(2):13-15.
[15]Healthcare Survey Instrument,2009.http://mentsurvey.org/wp-content/images/2011/01/Healthcare_Survey_Instrument_20110110.pdf
[16]Williams L J,Vandenberg R J,Edwards J R.Structural Equation Modeling in Management Research:A Guide for Improved Analysis[J].Academy of Management Annals,2009,3(1):543-604.