Study On The Claims Of Supplier In Synergetic Supply Of County Public Health Service

Objective:This study defines the concept of synergetic supply of county public health service.The study investigates the interests claims of supplier for synergetic supply of county public health service,and clarifies the relationship between interests claims.The game between suppliers is proposed to provide an empirical reference for balancing the interests of all parties and to provide impetus for the realization of collaborative supply.Methods:(1)Literature research: To review the relevant literature,define the concept of synergetic supply of county public health service,summarize suppliers’ interests claims.(2)SWOT analysis: To analyze the advantages,disadvantages,opportunities and threats of synergetic supply of county public health service.(3)Expert consultation: Scholars of county public health service management and research,leaders of health administrations and senior public health workers were invited to consult and determine supplier’ interests claims and classification of claims.(4)Questionnaire survey: Multi-stage stratified sampling was conducted in 6 counties of 3 provinces in the eastern,middle and western regions of China.To investigate the claims of the suppliers,and questionnaires were sent to County Health and Family Planning Commission,medical and health service institutions and medical staffs.(5)Statistical analysis: Mathematical statistics analysis was conducted to clarify the interests claims and influencing factors of suppliers.Game model analysis was used to find the equilibrium of the game.Results:(1)The interests claims of suppliers.The interests claims of County Health and Family Planning Commission are information,business and process synergy of medical and health service institutions,cultural synergy,strategic synergy and organizational synergy.The interests claims of medical and health service institutions are information synergy and knowledge sharing,strategic synergy,capital synergy,business synergy,cultural synergy.The interests claims of medical staffs are good working environment and welfare benefits,business synergy,social recognition,knowledge sharing,information synergy.(2)Differences analysis of interests claims among different characteristic subjects.There were significant differences in interests claims of County Health and Family Planning Commission staffs in information,business and process synergy(P<0.05).There were significant differences in interests claims of different types of public health service supply model in strategic synergy(P<0.05).There were significant differences in interests claims of different types of medical and health institutions in information synergy and knowledge sharing,strategic synergy,capital synergy,business synergy,cultural synergy(P<0.05).There were significant differences in interests claims of medical staffs in good working environment and welfare benefits,business synergy,social recognition,knowledge sharing,information synergy(P<0.05).(3)As County Health and Family Planning Commission increases the cost of supervision of medical and health institutions,the probability of supervision of medical and health institutions will be reduced.As the reputation gains of medical institutions increase,County Health and Family Planning Commission will reduce the probability of supervision.With the increase of the supervision,punishment and the reputation loss of County Health and Family Planning Commission,the probability of public welfare operation of medical and health service institutions will improve.The game equilibrium of county and township medical institutions is(not cooperating,not cooperating),and the gains are less than the benefits of adopting(cooperating,cooperating)strategy.The greater additional benefits and the smaller fines that medical staffs are not work hard,the greater probability that the medical and health institutions choose to supervise.The lower cost of medical and health service institutions’ supervision and the greater fines that medical staffs are not work hard,the greater probability that medical staffs will choose an effort strategy.Conclusions:The difference of interest demand is the resistance to the realization of coordinated supply.The common interest appeal is the motive force that the coordinated supply realizes.The game between County Health and Family Planning Commission and medical and health institutions affected by reputation factors.There is a “prisoner’s dilemma” between different suppliers.Costs and benefits impact strategic choices of medical and health institutions and medical staffs.It is necessary to construct the mechanism of balancing claims,to resolve the conflicts of interests claims.Synergetic supply of county public health service should be promoted based on common interests.Social supervision should be conducted to maintain the public welfare of public health services.Government guidance should be strengthened to promote cooperation among suppliers.Internal supervision should be strengthened to regulate the behavior of medical staffs.