军队医院综合质量评价指标体系的研究与应用

Study and application of comprehensive quality evaluation index system of military hospitals

目的 :对原有的军队医院医疗护理质量综合评价指标体系进行修订和完善 ,以全面反映医院医疗护理质量的动态变化 ,合理、科学地评价医院的综合管理工作 ,进行科学决策。方法 :在专家咨询与现场调研的基础上 ,应用数理统计学中的聚类分析和主成分分析等方法 ,对医疗护理质量指标进行筛选和分组 ,再结合病种质量指标和危重病例构成比 ,运用综合指数法对 2 4所军队医院的医疗护理质量进行综合评价。结果 :运用新的综合质量评价指标体系及新的评价方法 ,明显改善了不同级别医院间的不可比现象 ,排序结果与专家咨询和医院的实际效绩相吻合。 结论 :新的医院综合质量评价指标体系考虑到了医疗护理工作中的环节质量和不同医院间的病种差异 ,综合评价结果更为合理 ,是医院管理决策中的有用工具 ,具有一定的推广应用价值。

Objective:To revise and improve the original comprehensive evaluation index system of medical and nursing quality in military hospitals, reflecting the dynamic variation of medical and nursing quality, and to evaluate the hospital performance appropriately for scientific decision. Methods: Based on expert consultation and field survey, several statistics methods such as cluster analysis and principal component analysis were used to select medical and nursing quality indexes, and these indexes were divided into subgroups. Then a comprehensive index method combined with indexes of disease entity quality and disease composing was employed to make a comprehensive assessment of medical and nursing quality in 24 military hospitals. Results: In terms of the new index system and evaluation method, the comparability among hospitals of different levels had been improved obviously and the hospital ranks were consistent with the results of expert consultation and hospital performance. Conclusion: The new comprehensive quality evaluation index system, considering the link quality of medical and nursing services and diversity of disease entities in different hospitals, is a more appropriate comprehensive evaluation result and is useful for policy making and worth to be popularized.