{"title":"是什么影响了中国患者参与医疗服务的意愿?中国政策和制度背景的视角。","authors":"Jingyan Zhu, Ping Sui","doi":"10.1002/hpm.3760","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>The benefits of involving patients and carers include improving health outcomes and safety, reducing costs and enhancing an open, accountable and equitable relationship between service providers and users. However, the willingness for involvement and participation is largely affected by a range of factors, including those at the micro, meso and macro levels. As the previous studies have given much attention to the factors at the individual level, it is worthwhile to explore the factors at the broader levels of the policy and institutional contexts. The objective of the research is to understand how the policy and institutional contexts in China affect how patients wish to be involved in their health care delivery.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>An abductive research strategy was used to generate emergent hypotheses in the first stage of data construction. In the second stage of fieldwork, hypotheses were tested using the deductive approach. Three local hospitals in Shandong Province, China, were selected. The case study method was designed with qualitative methods of policy documents and interviews. Interviews included health professionals, health board managers, local administrators and service users. Thematic analysis and framework analysis were conducted.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Four policy and institutional contexts were identified: insufficient policy support, the current institutional design of involving users, the heterogeneity of organisational autonomy and resources, as well as the demography of the population of service users.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>As a policy strategy at the state level, there is a lack of policy support for patient involvement and participation in the Chinese health system. The heterogeneity of the institutional context of health facilities plays a key role in affecting how patients wish to be involved in health care delivery.</p>\n </section>\n </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"What affects how Chinese patients wish to be involved in health care delivery? Perspectives of the Chinese policy and institutional contexts\",\"authors\":\"Jingyan Zhu, Ping Sui\",\"doi\":\"10.1002/hpm.3760\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>The benefits of involving patients and carers include improving health outcomes and safety, reducing costs and enhancing an open, accountable and equitable relationship between service providers and users. However, the willingness for involvement and participation is largely affected by a range of factors, including those at the micro, meso and macro levels. As the previous studies have given much attention to the factors at the individual level, it is worthwhile to explore the factors at the broader levels of the policy and institutional contexts. The objective of the research is to understand how the policy and institutional contexts in China affect how patients wish to be involved in their health care delivery.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>An abductive research strategy was used to generate emergent hypotheses in the first stage of data construction. In the second stage of fieldwork, hypotheses were tested using the deductive approach. Three local hospitals in Shandong Province, China, were selected. The case study method was designed with qualitative methods of policy documents and interviews. Interviews included health professionals, health board managers, local administrators and service users. Thematic analysis and framework analysis were conducted.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Four policy and institutional contexts were identified: insufficient policy support, the current institutional design of involving users, the heterogeneity of organisational autonomy and resources, as well as the demography of the population of service users.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>As a policy strategy at the state level, there is a lack of policy support for patient involvement and participation in the Chinese health system. The heterogeneity of the institutional context of health facilities plays a key role in affecting how patients wish to be involved in health care delivery.</p>\\n </section>\\n </div>\",\"PeriodicalId\":47637,\"journal\":{\"name\":\"International Journal of Health Planning and Management\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-01-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Health Planning and Management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hpm.3760\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Health Planning and Management","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hpm.3760","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
What affects how Chinese patients wish to be involved in health care delivery? Perspectives of the Chinese policy and institutional contexts
Introduction
The benefits of involving patients and carers include improving health outcomes and safety, reducing costs and enhancing an open, accountable and equitable relationship between service providers and users. However, the willingness for involvement and participation is largely affected by a range of factors, including those at the micro, meso and macro levels. As the previous studies have given much attention to the factors at the individual level, it is worthwhile to explore the factors at the broader levels of the policy and institutional contexts. The objective of the research is to understand how the policy and institutional contexts in China affect how patients wish to be involved in their health care delivery.
Methods
An abductive research strategy was used to generate emergent hypotheses in the first stage of data construction. In the second stage of fieldwork, hypotheses were tested using the deductive approach. Three local hospitals in Shandong Province, China, were selected. The case study method was designed with qualitative methods of policy documents and interviews. Interviews included health professionals, health board managers, local administrators and service users. Thematic analysis and framework analysis were conducted.
Results
Four policy and institutional contexts were identified: insufficient policy support, the current institutional design of involving users, the heterogeneity of organisational autonomy and resources, as well as the demography of the population of service users.
Conclusions
As a policy strategy at the state level, there is a lack of policy support for patient involvement and participation in the Chinese health system. The heterogeneity of the institutional context of health facilities plays a key role in affecting how patients wish to be involved in health care delivery.
期刊介绍:
Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.