Evaluation of the Collaboration Among Different Urban Medical Collaboration Systems Based on Factor Analysis

Abstract

Objective: To evaluate the situation of urban medical collaboration under different modes and come up with suggestions for improvement in order to provide references for further collaboration.

Methods: The study identified three major collaborative modes: loose cooperative mode of Nanjing Zhongda Hospital, Gulou Hospital and community health service centers (loose mode); the mode of community health service centers under the direct administration of the Fifth Hospital of Wuhan (direct administration mode); the medical group mode of Zhenjiang (consortium model). The medical workers and administrators of cooperative hospitals and community health service centers under the three collaborative modes were chosen as subjects. In September 2013, we conducted field investigations on the subjects, and the questionnaire content included basic information, the situation and major barriers of collaboration, and the evaluation of collaboration, etc. On the basis of literature reading and expert consultation and according to the preliminary studies, we selected 13 indexes for the evaluation of collaboration status. Main components were extracted using factor analysis, and comprehensive analysis was made on the collaboration status evaluated by subjects under different modes and of different occupations.

Results: Four common factors were extracted, namely chronic disease prevention and management, diagnosis and treatment, information continuity, and further education on professional work. The comprehensive scores given on collaboration status by subjects under loose mode, direct management mode and consortium mode were -0.12, 0.17 and -0.08 respectively, and the comprehensive scores given on the collaboration status by medical workers and administrators were -0.02 and 0.05 respectively.

Conclusion: Comprehensive evaluation on the collaborative mode can be performed in terms of four factors which are chronic disease prevention and management, diagnosis and treatment, information continuity, and further education on professional work. Difference exists in the score of each factor under each mode. Inconsistency exists in the collaboration status evaluated by managers and medical workers, thus effective strategies for benefit adjustment and proper incentive mechanism are needed.