因子分析法在医院医疗质量评价中的应用

Synthetic evaluation of hospital medical quality by factor analysis

目的分析医疗质量指标的潜在影响因素,综合评价医疗质量,探寻不同阶段医疗质量的变化情况。方法用因子分析法统计山东大学附属省立医院2007年1月至2008年12月的14项医疗指标,包括总诊疗人次、出院人次、手术台次、床位使用率、床位周转次数、平均住院日、治愈好转率、病死率、入院与出院诊断符合率、病理与临床诊断符合率、手术前后诊断符合率、院内感染率、平均住院费用、无菌手术甲级愈合率,使用SPSS16.0软件进行统计学处理。结果从14项指标中提取出3个公因子,第一公因子为医疗数质量因子;第二公因子为医疗水平因子;第三公因子为医疗感染因子。3个公因子的累积方差贡献率达75.04%;2年间总因子得分同期相比均上升。结论医疗数质量因子、医疗水平因子和医疗感染因子是医疗质量指标的主要影响因素,因子得分可以为医疗质量综合评价提供指导建议。

Objective To analyze potential factors affecting indicators of medical quality,to synthetically evaluate the medical quality,and to explore the change of the medical quality in different stages.Methods With SPSS 16.0,14 quality indicators were analyzed by factor analysis from Jan 2007 to Dec 2008,including number of outpatients,the number of discharges,number of operations,rate of bed utilization,frequency of bed rotation,length of hospital stay,rate of cure and improvement,case fatality rate,coincidence rate of admission and discharge diagnosis,coincidence rate of pathological and clinical diagnosis,coincidence rate of preoperative and postoperative diagnosis,hospital complication rate,mean hospitalization cost,and grade A healing rate of aseptic operations.Results Three common factors were extracted： the quantitative and qualitative factor,medical level factor,and complication factor.The cumulative contribution rate of the 3 factors was 75.04%.The synthetic factor scores were ascending over the same stages of the two years.Conclusion The quantitative and qualitative factor,medical level factor and complication factor are the potential affecting factors,and synthetic factor scores can provide evidence for synthetic evaluation on hospital medical quality.