The Strategy Analysis Of Home Delivery Service Of Peritoneal Dialysis Fluid Based On Stakeholder Perspectives

Objective To understand current research and development status of home delivery service for peritoneal dialysis fluid, define and analyze stakeholders relevant to the home delivery service,study and discuss the benefit, influence level and position of each stakeholders. To reveal the obstacle factors in the development and promotion of home delivery service, put forward corresponding strategies and suggestions.Methods Based on data from website of National Bureau of Statistics of the People’s Republic of China, Jiangsu and Shanxi province bureau of statistics,annual report of ESRD Patients in 2004-2015 A Global Perspective and qualitative interview data, choose Jiangsu and Shanxi provinces as the survey area,use Mitchell score method to determine the type of stakeholders,use professional’s score to analyze the interests and position of stakeholders.Then design interview outlines of key stakeholders framework by SWOT ananlysis based on above factors, combine with social factors to analyze the strengths, weaknesses, opportunities and threats in home delivery service.Results 1 Current investigation of home delivery service Between Jiangsu and Shanxi provinces, the imbalance phenomenon reflected in 1)the level of social and economic development, the residents and rural residents per capita disposable income is 34346 yuan,34346 in Jiangsu and 24366 yuan, 7932 yuan in Shanxi respectively;2) the promotion level of peritoneal dialysis, there are 74 hospitals carry out peritoneal dialysis in Jiangsu and 11 in Shanxi; 3)the configuration of health resources between peritoneal dialysis and hemodialysis, the average ratio of hemodialysis nurses and patients in 7 hospitals in Jiangsu is 1:11, the average ratio of peritoneal dialysis nurses and patients in 7 hospitals in Jiangsu is 1:45,the ratio in Shanxi is1:10 and 1:87.5 respectively; 4) the follow-up system of peritoneal dialysis,it focus on outpatient follow-up and telephone follow-up, home follow-up is absent; 5)the development of home delivery service in above two provinces, ESRD patients in Jiangsu mainly accept home delivery service, but most patients in Shanxi need to get peritoneal dialysis fluid by themselves.2 Stakeholder analysis of home delivery service Home delivery service of home peritoneal dialysis include 4 definitive stakeholders, such as health department, pharmaceutical supervisory and administrative department medical insurance department and medical institution,2 excepted stakeholder including patient and professional association, 4 potential stakeholders to be manufacturing and distribution enterprise,medical staff and social media. They show different interests and position for home delivery service. For interest level and interest influence index, the score of patient is highest, and medical insurance department is lowest; for the score of interest influence level, the highest is manufacturer, the lowest is medical staff; All stakeholders support to the home delivery service of peritoneal dialysis fluid,but compare to the high position index from patient, medical staff, manufacturer and distribution enterprise,the position index of supervisor is lower.3 the strategy analysis of home delivery service The strengthens of home delivery service includes meet the demands of interests of part interest groups; have good stakeholder foundation; distribution companies invest large human and financial resource; reduce patients’ burden;patients show high willingness and satisfaction home delivery service; reduce medical staffs’ burden; reduce medical institutions inventory pressure; medical staff support to home delivery service; the diversity of home delivery service. The weaknesses includes the interest level, affect level and impact index of stakeholders is different.; distribution security is challenged; distribution with compliance problems; Service attributes definition is not clear; Responsibility body is unknown; the high cost of distribution; the lack of a unified and standard information management. The opportunities includes the international successful experience; ESRD patients increase gradually; market competition of peritoneal dialysis fluid has intensified; the logistics distribution network widening gradually;social economy level and residents’ income level increase gradually; Highway transportation developed step by step. The threats includes external policy diseconomy, suffer laws and regulations policy barriers; Government departments lack of understanding and attention to it; luck of funds support; the level of economic development and transportation development is imbalance among regions.Conclusion The study mainly introduces the basis situation in Jiangsu and Shanxi provinces by literature analysis, expert consultation, questionnaire survey and key informant interviews and analyzes the benefit, influence level and position of each stakeholder of home delivery services systematically, use SWOT analysis method to analyze the strengths, weaknesses, opportunities and threats in home delivery service. The study indicates that the distribution of two kinds of dialysis therapy and the development of home delivery service shown unbalanced among regions; the stakeholders of home delivery service include health department, pharmaceutical supervisory and administrative department, medical insurance department and medical institution and so on, They show different interests and position for home delivery service; the development of home delivery service face the evidence-based demands of the localization in China; the development of home delivery service need with local development opportunities, fully draw on international development experience and fully play the internal advantage of interest groups to overcome problems such as security, compliance, liability and define of responsibility attributes.