Motives and tactics for township health centers to take part in countywide medical communities of Shandong province

Abstract

Objective To analyze the motives and tactics of township health centers (THC) to participate in the countywide medical communities of Shandong province. Methods Such tools as the new institutionalism, rational choice and social network theories, as well as the constituent ratios and Pearson correlation coefficient of data were used in a survey in August 2018 with managers of 264 THCs in Shandong. It aimed to learn from the respondents their motives, tactics, and behaviors to participate in such communities. Results Theoretical analysis of the results found that their participation was bound by both institutional environment and technical environment. For example, compliance tactics, accompanied by efficiency, was adopted to cope with stress from institutional environment. Exploratory tactics, accompanied by legitimacy, was adopted to cope with stress from technical environment. The figures showed 87.5% of 264 THCs investigated participated in such communities, and their main motives were in turn to follow government requests (86.1%) and to seek development opportunities (69.7%). The critical criteria of partner selection were in turn technological level (83.5%) and matching of resources (77.9%). Of 231 THCs which participated in the communities, 95.2% joined in countywide medical communities, and 28.6% participated in other forms of medical alliances. Conclusions THCs showed high organizational convergence in their participation, and adopted diversified strategies of participation in medical alliance. Key words: Rural health services; Medical community; Participating motives; Institutional environment; Technical environment