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

摘要：

背景　医师多点执业是促进优质医疗资源下沉的重要举措，医院管理者是影响医师多点执业的重要因素，从医院管理者视角探讨医师多点执业存在的问题并提出相应的对策，有利于医师多点执业的推行。目的　应用扎根理论方法结合质性研究软件NVivo 11.0，从医院管理者视角探讨贵州省医师多点执业的问题并提出相应对策。方法　于2017年1—11月按照目的抽样结合理论抽样的方法对贵州省9个市/州53家医疗机构的78名管理者进行半结构化访谈，经开放式编码、主轴编码、选择性编码对医师多点执业的相关问题进行深入研究。结果　经过三级编码，最终梳理出与医师多点执业相关的1 373个自由节点、102个树状节点、10个范畴、5个主范畴及3个核心范畴。核心范畴为发展前景、限制因素及执业条件。最后形成一条故事线：现阶段医院管理者认为虽然医师多点执业利弊共存并受多种因素制约，但是是发展趋势；执业形式应轮流由医院派出或在医疗联合体内开展多点执业，所获利益应由医师本人及其所在医院、科室共享，但对医疗责任损害分担的认识存在差异。结论　在不损害第一执业机构权益，并合理分配多点执业所获利益和分担医疗损害责任的基础上，医院管理者支持医师多点执业。

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