摘  要 目的：基于利益相关者理论，确定县域公共卫生服务多元主体协同供给中的利益相关者及其诉求，为县域公共卫生服务多元主体协同供给的发展提供科学依据。方法：通过文献研究和头脑风暴法，提出县域公共卫生服务多元主体协同供给利益相关者。利用米切尔评分法设计利益相关者专家咨询表。通过两轮专家咨询，对利益相关者进行界定和分类。采用问卷调查的方法对核心利益相关者的利益诉求进行研究。应用因子分析、秩和检验等方法对调查数据进行分析。结果：本研究共界定出38个县域公共卫生服务多元主体协同供给利益相关者。其中，核心利益相关者包括：县卫计委、医疗卫生服务机构、医务人员、农村居民。县卫计委利益诉求：医疗卫生服务机构战略、文化、组织、业务、信息、流程协同以提高农村居民对公共卫生服务的满意度。医疗卫生服务机构利益诉求：医疗卫生服务机构战略、文化、信息、知识、资金流、业务、制度的协同。医务人员利益诉求：良好的工作环境、福利待遇和社会认可以及业务协同、知识共享。农村居民利益诉求：获得安全、有效、方便、价廉的公共卫生服务。结论：县域公共卫生服务多元主体协同供给需要以政府为主导，平衡各利益相关者的利益诉求，增强医疗卫生服务机构间的协同能力，从而实现县域公共卫生服务多元主体的协同供给。90213

毕业论文关键词：县域；公共卫生服务；多元主体；协同；利益相关者

ABSTRACT Objective: To determine stakeholders and their interests claims of multi-subject synergistic supply of public health service in county area based on the stakeholder theory, and provide scientific basis for multi-subject synergistic supply of public health service in county area development。 Methods: The stakeholders of multi-subject synergistic supply of public health service in county area were tentatively proposed through the literature research and brainstorming method。 On the basis, the expert consultation scale was developed by using the Mitchell score-based approach for reference。 The stakeholders were confirmed and classified through two rounds expert consultation。 Interests claims of the stakeholders were studied through questionnaire survey。 Investigation data were analyzed with factor analysis and rank-sum test。 Results: This study defines 38 public health service multi-subject synergistic supply for stakeholders in county area。 The core stakeholders include the Health and Family Planning Commission of County-level, Medical and Health Service Institutions, medical personnel and rural residents。 The interests claims of the Health and Family Planning Commission of County-level: the synergism of strategy, culture, organization, business, information and process among Medical and Health Service Institutions, in order to improve rural residents’ satisfaction for public health service。 The interests claims of Medical and Health Services: the synergism of strategies, culture, information, knowledge, capital flow, business among Medical Health Service Institutions。 The interests claims of medical staff: good working environments, welfare benefits, social recognition, business synergism and knowledge sharing。 Rural residents' interests claims: access to safe, effective, convenient and cheap public health service。 

Conclusion: Multi-subject synergistic supply of public health service in county area should take the government as the leading role, balance the interests claims of all stakeholders, so as to realize the synergistic supply of multi-subject public health service in county area。

Keywords: county area; public health service; multi-subject; synergism; stakeholders

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