基于计划行为理论的医生临床路径依从行为研究

项目名称： 基于计划行为理论的医生临床路径依从行为研究

项目编号： No.71303012

项目类型： 青年科学基金项目

立项/批准年度： 2014

项目学科： 管理科学

项目作者： 孙杨

作者单位： 北京大学

项目金额： 22万元

中文摘要： 医生的实际诊疗行为决定了医疗质量与费用的合理性。既往的研究很少对介于医生行为模式影响因素和行为效果产出之间的特定行为主观决策过程进行分析。临床路径依从行为反映医生对医疗质量的尊重和对医疗费用合理性的关注。 课题拟在病种临床路径支付制度改革背景下，对医生临床路径依从行为进行理论研究和实证分析。通过对医生临床路径依从行为进行界定，和6所典型医院相关病种患者所接受诊疗服务的调查，测量和描述医生临床路径依从行为现状和所产生的效果产出。基于计划行为理论和对医生临床路径依从行为决策的实证分析，建立医生临床路径依从行为模型。 研究将阐述医生行为模式影响因素、医生行为信念-态度-意图、行为发生，以及行为效果产出的内在关系和发生机制，揭示行为决策对行为发生的关键作用，探讨预测和干预医生临床路径依从行为的方法和路径。课题基于理论和科学证据，将针对性的为病种临床路径支付方式改革和医疗质量促进提供政策建议。

中文关键词： 医生；临床路径；行为；计划行为理论；支付方式

英文摘要： Clinic behavior of Physician determines the reasonableness of quality and cost of medical cares. Few previous studies have analyzed the subjective decision-making process of specific behavior, which usually between the impact of physician behavior patterns affect factors and the behavior output. Physician adherence to clinical pathway shows physician's respect to the medical care quality and reasonable concern to services cost. In the context of case & clinical pathway-based payment system reform in China, this research intend to study physician clinical pathway adherence behavior by theoretical and empirical analysis. The first, based on definition of physician clinical pathway adherence behavior, and survey to clinic services, expenditure, that case-based patients received and paid in six typical hospitals, to measure and describe the target behavior status and output. Second, to create a model of physician clinical pathway adherence behavior, based on theory of planned behavior and empirical analysis of decision-making process of clinical pathway adherence behavior. Finally, the study intent to elaborate the intrinsic relationship and behavior occur mechanism, among physician behavior patterns influencing factors, physician behavioral belief - attitude - intention, behavior, and the output of behavior,

英文关键词： Physician；Clinical Pathway；Behavior；Theory of Planned Behavior；Payment