通讯作者: 陆方, lufang@njmu.edu.cn

DOI：10.12201/bmr.202304.00009

Research on cooperation outcome of medical and nursing institutions based on reciprocity theory

• 摘要：随着老龄化的快速发展，老年人对医疗和养老的双重需求日益增长，医疗机构和养老机构的合作如何有效开展，成为社会关注的热点。基于互惠理论分析框架，采用扎根研究与多案例研究方法，对公对公模式、公建民营模式、公对私模式三家合作案例进行编码，对合作不同阶段合作方的互惠行为及其演变过程进行探析，厘清互惠行为对合作结局的影响。研究发现，由于合作各方所有权性质不同，可以做出的互惠行为调整也有所差异，从而影响合作方的态度，最终导致出现不同合作结局。公对公模式中公立养老机构决策自主性和灵活性较低，易出现互惠强度的不对等，从而影响合作方的态度，合作易破裂；公建民营模式中民营合作方由于其建设压力较小可以集中于机构运营，加之政府提供持续互惠，合作容易顺利推进；公对私模式中，民营养老机构自主性和灵活性较强，双方可以通过资源互补实现共赢发展。因此，对于公对公合作模式应扩大公立养老机构服务范围，给予其运营方面更多自主权；对于公建民营合作模式政府应针对合作不同时期精准施策，持续助力机构发展；对于公对私合作模式政府应出台相关技术标准，使得合作双方有据可依，对于医养结合机构应不断拓展合作范围，实现共赢发展。

  关键词： 医养结合机构；合作结局；互惠行为；合作模式

   

  Abstract: With the rapid development of aging, the dual needs of the elderly for medical care and elderly care are growing day by day. How to effectively carry out the cooperation between medical institutions and elderly care institutions has become a hot topic of social concern. Based on the analysis framework of reciprocity theory, using the methods of grounded research and multi case study, this paper codes three cooperation cases, namely, the public to public model, the public to private model, and the public to private model, analyzes the reciprocal behaviors of both parties in different stages of cooperation and their evolution process, and clarifies the impact of reciprocal behaviors on cooperation outcomes. It is found that due to the different ownership nature of cooperative parties, the reciprocal behavior adjustment can be different, which will affect the attitude of cooperative parties and eventually lead to different outcomes of cooperation. In the public-to-public mode, the decision-making autonomy and flexibility of public pension institutions are relatively low, which is prone to the asymmetry of reciprocity intensity, which affects the attitude of partners and leads to the breakdown of cooperation. In the private mode of public construction, private partners can focus on institutional operation due to less construction pressure, and the government provides continuous reciprocity, so the cooperation is easy to move forward smoothly. In the public-private mode, private pension institutions have strong autonomy and flexibility, and both sides can achieve win-win development through resource complementarity. Therefore, the public-to-public cooperation mode should expand the service scope of public pension institutions and give them more autonomy in operation. For the public-private cooperation model, the government should take precise measures according to different periods of cooperation and continue to help the development of institutions. For the public-private cooperation model, the government should issue relevant technical standards, so that both parties can rely on the basis of the cooperation, and for the combination of medical and nursing institutions should continue to expand the scope of cooperation, to achieve win-win development.

  Key words: Medical and nursing institutions；Cooperation outcome；Reciprocal behavior；Cooperation mode

  提交时间：2023-04-10

  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	2022-11-28	bmr.202304.00009V1	下载

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