关键词: 医师多点执业, 医院管理人员, 扎根理论, NVivo 11.0, 定性研究

Abstract: Background　The implementation of multiple-site physician practices is an important measure to promote the allocation of high-quality medical resources to primary care.As hospital managers are a key factor associated with multiple-site physician practices，their perspectives on problems and countermeasures in multiple-site physician practices are contributive to the promotion of such practices.Objective　To discuss the problems and countermeasures in multiple-site physician practices in Guizhou Province from hospital managers' perspectives using grounded theory and NVivo 11.0 qualitative data analysis software.Methods　This study was conducted from January to November in 2017.Useing purposeful and theoretical sampling，78 managers were recrited from 53 medical institutions in 9 cities/prefectures，Guizhou Provinces.Data were obtained by using a semi-structured interview approach.Problems concerning multiple-site physician practices were intensively studied with open coding，axial coding and selective coding.Results　After three stages of coding，1 373 free nodes，102 tree nodes，10 categories and 5 main categories and 3 core categories were determined.The three core categories include development prospects，limiting factors，practice conditions.Then a story line was formed as follows：the hospital managers assumed that the implementation of multiple-site physician practices has advantages and disadvantages，and its development shows an upward trend although there are many hinderances.Physician understaking multiple-site practices should be alternately dispatched or should be practiced in the member institutions of a regional medical consortium，and the profits obtained from multiple-site practices should be shared by the physician，the hospital and department where he works，but the managers did not reach a consensus regarding the responsible parties which should be liable for medical malpractice.Conclusion　The hospital managers supported physicians undertaking multi-site practice，under the prerequisite that the rights and interests of the primary practice site should not be impaired，and that the allocation of benefits as well as medical damage liability of multi-site practices are determined reasonably.

Key words: Physician multi-site practice, Hospital administrators, Grounded theory, NVivo11.0, Qualitative research