Zhongguo quanke yixue (Apr 2022)
Influencing Factors and Path Combination of County Medical Community Innovation by Local Government：a Crisp Set Qualitative Comparative Analysis
Abstract
BackgroundThe analysis of the influencing factors of local government innovation has always been an important topic in the research of local government innovation.ObjectiveTo analyze the influencing factors and various combination types of local government's practice innovation toward county medical community.MethodsIn March 2021, the preliminary results of the 2nd "Searching for Value Cases of County Medical Community Practice" held by the County Medical Community Branch of the China Hospital Association was used as the source of cases; The "type of policy innovation" was used as the outcome variable ("central dominative innovation"/"local responsive innovation"=0; "local autonomous innovation"=1) ; The level of economic development, administrative level, geographical location, problem attributes, and platform were used as condition variables; The crisp set qualitative comparative analysis (csQCA) was used to explore the factors influencing the county medical community innovation by local government, in order to constructthe path models of innovation practice through necessary condition analysis and conditional combination analysis.ResultsThe consistency of all five conditional variables was<0.9, which meant that the level of economic development, administrative level, geographical location, problem attributes, and platform were not necessary conditions for autonomous innovation. The results of conditional combination analysis (based on intermediate solution) showed that a total of five sets of sufficient conditions were obtained, including "the level of economic development and non-geographical location and platform" "administrative level and non-geographical location and platform" "the level of economic development and problem attributes and platform" "non- the level of economic development and geographical location and non-problem attributes and platform" "the level of economic development and administrative level and geographical location and problem attributes", separately. All five groups had a sufficient condition consistency index of 1, original coverage of 0.14-0.43, net coverage of 0.14-0.43, and overall coverage of 1. The innovation practice of local government's medical community practice mainly presents two types of models, namely platform innovation model and motivational innovation model.ConclusionIf local governments want to achieve high-level medical community innovation practice, they should pay attention to the strong correlation between policies and local economic development levels, activate local governments' willingness to innovate actively, and strengthen platform support for county medical communities. This study provided a special reference significance for understanding the practice innovation mechanism of county medical community.
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