基于RSR的相同级别综合医院临床手术科室综合绩效比较分析方法的探讨

Comprehensive performance analysis of different surgical departments of the same grade comprehensive hospitals with RSR method

目的 探讨相同级别综合医院临床手术科室综合绩效的比较方法.方法 采用秩和比法对成都市2所三级甲等综合医院住院临床手术科室2009年绩效指标进行综合评价,横向比较各院手术科室的综合绩效水平.结果 A院眼科的绩效优于B院（综合评价绩效以RSR的反正弦平方根代换值（Y）的95%可信区间表达）分别为57.79～77.65、38.48～58.34（P〈0 05）,B院泌尿外科和耳鼻咽喉科的绩效（55.58～75.44,60.76～80.62）均优于A院（33.28～53.14,31.12～50.98）（P〈0.05）,2所医院相同专业的手术科室综合绩效水平存在着不同程度的差别,有差异化发展的趋势.医疗指标综合评价结果,A院优于B院（t=2.815,P=0.025）,2所医院临床手术科室的手术负荷以及综合绩效的差别均不显著（t=1.234,P=0.256;t=1.321,P=0 228）.结论 对同级医院进行横向对比分析,可客观评估医院的优势和不足,有助于医院管理者适时调整学科建设重点,发挥优势学科的长处,促进临床各专业全面发展.

Objective To explore the method of comparing the comprehensive performance of surgical departments of different comprehensive hospitals of the same grade. Methods The Rank sum ratio （RSR） method was used to evaluate the performance of surgical department of two hospitals with Grade III level A in Chengdu 21309 comprehensively. Results The performance of ophthalmology department of hospital A （95% CI of the square root transformation of arcsin of RSR, 57.79 - 77.65 ） surpassed that of hospital B （38.48 - 58.34, P〈0.05）. However, Urology surgery and Department of otolaryngology of hospital A were inferior to hospital B （55. 58 -75.44 VS. 33.28 -53.14, 60.76 -80.62 VS. 31.12-50.98, P〈0. 05 respectively）. The difference of the departments of the two hospitals represented different superiority. The comprehensive evaluation of medical service quantification index of hospital A was supe- rior to that of hospital B （t = 2. 815,P= 0.025）. There was no significant difference of surgical load and comprehensive performance between the two hospitals （t=1. 234,P=0. 256;t=1.321 ,P=0.228, respectively）. Conclusion It＇s helpful for hospital managers to improve the development of different disciplines by adjusting the emphasis of the discipline construction by evaluating the superiority and insufficiency of the hospitals in the same grade with RSR method.