农村医疗机构诊治技术优化和补偿机制改革试点研究效果评价方法

The Method of Outcome Evaluation of Pilot Research on Health Technology Optimization and Compensation Mechanism in Rural Health Facility

目的:评价试点研究的干预措施是否产生了预期效果。方法:在准实验设计中采用干预前后带有对照组的实验设计,在中期和末期两个时间点对干预措施进行评价;通过比较干预前后医疗费用的变化,判断干预措施的临床效果;选择两个与试点医疗机构相匹配的医疗机构作为对照组,应用倍差法比较试点组与对照组干预前后治疗效果及费用变化之差。同时应用定性的方法评价、分析干预措施与干预结果的内在机理。结果:该评价方法应用到干预试点研究阶段性评估,得到世界银行和NICE专家的认可。结论:该评价设计对这种综合干预措施的评价是可行有效的。

Objective：to evaluate if the intervention produces the expected effect.Methods：the quasi-experimental study design of pre-post study with one comparison was applied to evaluate outcomes at middle and final two time points;by comparing the change in medical cost before and after the intervention,to estimate the effect of intervention;by choosing two hospitals which are very similar to intervention hospitals as comparisons,difference in difference was used to compare the difference in changes at pre-post intervention between study group and control group.The qualitative evaluation was used to analyze internal mechanism between interventions and outcomes.Results：the evaluation design was applied to do a staged evaluation of the pilot study,and experts from the World Band and NICE accepted the design.Conclusion：It is feasible and effective to use quasi-experimental evaluation design to evaluate a project with comprehensive interventions.