通讯作者: 张子楠, zinan1988@njmu.edu.cn

DOI：10.12201/bmr.202502.00049

Governance Mechanism and Organizational Collaboration of the Merged County Medical Community from the Perspective of Multiple Institutional Logics: Theoretical mechanism and Empirical Test

• 摘要：目的：探究紧密型县域医共体中的治理机制对组织协同的作用机理。方法：基于制度逻辑理论，对县域医共体中的科层、市场、社区等多重制度逻辑进行分析，明确对应形成的行政机制、竞争机制、关系机制等治理机制，构建治理机制对组织协同的作用机理框架，以全国范围内县域医共体中的235个乡镇卫生院作为样本，运用路径分析法对县-乡协同、乡-村协同两个模型进行实证检验。结果：在县-乡协同模型中，共存在7条路径，行政机制和竞争机制直接影响组织协同，同时组织利益和需要认知在其中起到部分中介作用；组织认知在关系机制和组织协同之间起到完全中介作用。在乡-村协同模型中，共存在4条路径，行政机制和竞争机制直接影响组织协同，组织利益认知在竞争机制和组织协同之间起到部分中介作用；组织利益认知在关系机制和组织协同之间起到完全中介作用。结论：行政机制是组织协同的基础；竞争机制对组织协同起到较大负向影响；关系机制是组织协同的重要保障；组织利益的提升能够直接提升组织协同。

  关键词： 县域医共体; 多重制度逻辑; 治理机制; 组织协同

   

  Abstract: Objective To explore the mechanism by which governance mechanisms within the merged county medical community affect organizational collaboration. Method Based on institutional logic theory, this study analyzes the bureaucratic logic, market logic, and community logic within the merged county medical community, clarifies the administrative mechanisms, competitive mechanisms, relational mechanisms, and other governance mechanisms arising from different logics, and constructs a framework for the role of governance mechanisms in organizational collaborative behavior. Using 235 township health centers within the merged county medical communities across the country as a sample, the study employs path analysis to empirically test the mechanism framework for county-township collaboration and township-village collaboration models. Results In the county-township collaboration model, there are a total of 7 pathways. Administrative mechanism and competitive mechanism directly influence collaborative behavior, while organizational interests and need cognition play a partial mediating role; organizational cognition fully mediates between relational mechanism and collaborative behavior. In the town-village collaboration model, there are a total of 4 pathways. Administrative mechanism and competitive mechanism directly influence collaborative behavior, with organizational interest cognition partially mediating between competitive mechanism and collaborative behavior; organizational interest cognition fully mediates between relational mechanism and collaborative behavior. Conclusion Administrative mechanism serve as the foundation for organizational collaborative behavior; competitive mechanism have a significant negative impact on organizational collaborative behavior; relational mechanism are an important safeguard for organizational collaboration; enhancing organizational interests can directly enhance collaborative behavior.

  Key words: Merged County Medical Community; Multiple Institutional Logics; Governance Mechanisms; Organizational Collaboration

  提交时间：2025-02-24

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2024-08-26	bmr.202502.00049V1	下载

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