【作者】 张倩；

【导师】 翟运开；

【作者基本信息】 郑州大学 ， 管理科学与工程， 2022， 硕士

【摘要】 新冠肺炎疫情期间,远程医疗在有效降低病死率及医护人员感染率方面发挥了不可忽视的重要作用。近年来,国家出台多项政策建设远程医疗系统,目前我国远程医疗系统已覆盖所有国家级贫困县县医院,然而有关数据表明远程医疗实际使用率低于30%,作为远程医疗服务关键提供者,医生参与远程医疗行为的积极性有待提高。在此背景下,探讨医生参与远程医疗行为的影响因素及政策干预路径不仅能够有效提升医生参与远程医疗的积极性,提高远程医疗实际使用率,而且能够为远程医疗政策指导行为提供更加可靠的决策依据。本文以医生为研究对象,首先参考顾客参与划分维度对医生参与远程医疗行为进行概念界定,基于前置-进行理论、计划行为理论、态度-行为-情境理论、人际行为理论构建医生参与远程医疗行为的政策干预路径理论模型;其次基于量表数据进行实证分析,对医生参与远程医疗行为意向的作用路径、医生参与远程医疗行为结果感知的回调效应及不同政策情境因素的调节效应分别进行验证,完成对理论模型的修正;继而基于实证分析结果构建复杂系统中的医生参与远程医疗行为的政策仿真模型,通过调整不同类型政策参数值实现对不同政策强度及组合作用力度的分析,挖掘复杂系统中提升医生参与远程医疗行为的最佳政策组合和实施力度;最后根据本文的研究结论,从提高医生参与远程医疗行为角度出发提出政策制定建议及具体策略,对本文的研究局限和未来研究展望进行产阐述。本文研究结果显示:(1)医生参与远程医疗行为意向是其参与行为的直接因素,个人远程医疗认知及态度和社会规范是其参与行为的前置动因;(2)医生参与远程医疗行为结果感知对医生参与行为意向和参与行为具有回调作用;(3)在复杂适应系统中,不同类型政策强度与医生参与远程医疗的行为呈现“U”型影响关系。研究结果明晰了医生参与远程医疗行为的关键影响因素及政策干预路径,并识别出复杂系统中远程医疗政策对医生参与行为的影响关系,能够为提升医生参与远程医疗行为积极性的政策制定与完善提供理论依据。更多还原

【Abstract】 During the COVID-19 pandemic,telemedicine played an important role in effectively reducing mortality and infection rates among healthcare workers.In recent years,China has issued a number of policies to build telemedicine systems.At present,the telemedicine system in China has covered all national hospitals in poor counties.However,relevant data show that the actual utilization rate of telemedicine is less than 30%.In this context,discussing the influencing factors and policy intervention path of doctors’ participation behavior in telemedicine can not only effectively improve the enthusiasm of doctors to participate in telemedicine and improve the actual utilization rate of telemedicine,but also can provide more reliable decision-making basis for telemedicine policy development in behavior guidence.In this thesis,doctors are taken as the research object.Firstly,the concept of doctors’ participation behavior in telemedicine is defined by referring to the classification dimension of customer participation,and the theoretical model of policy intervention path for doctors’ participation in telemedicine is constructed based on the theory of precede-proceed,the theory of planned behavior,the attitude-behavior-situation theory and the interpersonal behavior theory.Secondly,based on the scale data,empirical analysis is carried out to verify the action path of doctors’ behavioral intention to participate in telemedicine,the callback effect of doctors’ perception of the behavioral outcome of telemedicine and the moderating effect of different policy situation factors,so as to verify the theoretical model.Then,based on the empirical analysis results,a policy simulation model is built about the doctors participation in telemedicine in complex systems,by adjusting the values of different types of policy parameters to analyze the different policy intensities and combination effects,so as to explore the optimal policy combinations and implementation intensities for promoting doctors’ participation in telemedicine;Finally,according to the research conclusions of this thesis,policy recommendations and specific strategies are put forward from the perspective of improving doctors’ participation in telemedicine,and the research limitations and future prospects are described.The research results show that :(1)Doctors’ behavioral intention to participate in telemedicine is the direct factor of their participating behavior,and personal telemedicine cognition and attitude and social norms are the prefactors of their participating behavior;(2)The perception of the outcome of doctors’ participation in telemedicine has a callback effect on doctors’ participation intention and participation behavior;(3)In the complex system,the intensity of different types of policies has a u-shaped influence on the behavior of doctors participating in telemedicine.The results clarify the key influencing factors of doctors’ participation in telemedicine and the policy intervention path,and identify the relationship between telemedicine policy and doctors’ participation in a complex system,which can provide a theoretical basis for improving the policy formulation and improvement of doctors’ participation in telemedicine.更多还原