基于计划行为理论的公立医院医生处方行为研究

处方行为是医疗活动的重要环节，不仅关系着医疗服务的质量和效率，也是医患纠纷与矛盾的触发点。近年来，针对医务人员诊疗行为学的研究日益增多，但鉴于医生处方行为的复杂性和测量难度，如何对其进行正确评估并加以应用仍是困扰学术界的一大难题。本项目试图围绕上述问题展开理论研究与实证探索，立足于我国公立医院改革的现实背景，基于计划行为理论构建框架，开发出适合我国国情的公立医院医生处方行为评估体系，实证评估我国公立医院医生处方行为，探讨导致医生出现不合理处方行为的主、客观因素与内在作用机制。在当前试图破除公立医院“以药补医”格局的背景下，研究结果可作为规范医生处方行为、遏制过度医疗行为的重要切入点。其意义在于一方面可以为医务人员诊疗行为学研究提供理论参考与方法学建议；另一方面也可为提高公立医院医生处方行为规范措施的针对性，控制医疗费用，构建和谐医患关系，完善公立医院改革措施提供依据。

Prescribing behavior, as the important medical action in clinical practices, is not only related with the quality and efficiency of health services, also is a major contributing factor to the emergence of medical disputes. Despite growing research on the health professionals’ behavior, the existing evidence remains insufficient to evaluate the doctors’ prescribing behavior appropriately due to the complicated features and methodological weaknesses. Accordingly, applying the theory of planned behavior as the theoretical framework, this project will construct the evaluation system and assess the doctors' prescribing behavior in public hospital, aiming to explore the key factors and the decision pathway of irrational prescribing. In the progress of ongoing public hospital reform in China, this study is expected to reveal certain issues that can affect the design of policies aiming at the rationalization of prescribing behavior and at mitigation of over-treatment. Hence, by shedding new light on the process of prescribing, the findings will hopefully contribute to ensure a better understanding of health professionals’ behaviors and to generate new and more effective strategies for improving doctors’ prescribing behavior, reducing the healthcare expenditure, enriching the doctor-patient relationship and promoting the public hospital reform.