运用综合指数法和秩和比法评价分析医疗质量

Comprehensive evaluation of medical quality by using Rank sum ratio method and comprehensive index method

目的通过对某军队医院2008～2015年医疗质量各项指标进行综合评价与分析，以期发现医疗质量的变化并从整体上把握医疗质量水平的变化趋势，为持续改进医疗质量、提高服务能力提供依据。方法通过文献资料分析，选取门急诊人次、出院人次、手术例数、床位使用率、床位周转次数、出院者平均住院日、入出院诊断符合率、治愈好转率、抢救成功率、住院均次费用、药品比例等11项医疗指标组成评价体系，运用综合指数法对该院近8年的医疗质量进行综合评价，利用秩和比法（RSR）分档法对医疗质量的发展情况进行分档。结果2008～2015年医疗质量综合指数不断上升，2015年和2014年的综合指数是分别是2008年的1．96倍和2．05倍，依据RSR值的排序与分档结果看，2008～2010年医疗质量偏低，2014—2015年医疗质量较好，其余年份医疗质量处于中等水平。结论该院在2008～2015年医疗质量不断提升，在保证医疗质量和医疗安全的前提下，通过多种彤式或途径减轻医务人员的工作负荷、提高医疗效率、提升技术含量，优化质量效益，不断提升医院的综合实力。RSR法和综合指数法综合考虑了医疗评价指标的重要性，能科学、客观地反映医院医疗质量，提高分析效能，使评价更为科学合理。

Objective To comprehensively assess and analyze the medical quality index, to grasp the overall trend of medical quality level, and provide the basis for the improvement of medical quality and service ability. Methods On the basis of literature analysis, the number of emergency visits and discharges, surgical cases, bed utilization rate, bed turns, average hospital stay, diagnosis coincidence rate between admission and discharge, cure and improvement rate, rescue achievement ratio, average hospitalization cost, proportion of drug cost, etc. medical indicators were made to evaluation system. The comprehensive index method were used to evaluate the medical quality of the last 8 years, and Rank sum ratio （RSR） method was used to grade the development of medical quality. Results The medical quality comprehensive index rose gradually in 2008 - 2015,and the eomprehensive index in 2015 and 2014 was 1.96 times and 1.96 times that of 2008,respectively. According to the sort of RSR values and step results, medical quality was low in 2008 - 2010 and better in 2014 - 2015, the medical quality in the rest of years were in the medium level. Conclusions The medical quality are improved in 2008 -2015. On the basis of ensuring the medical quality and medical safety, a variety of forms are carried out to reduce the workload,improve medical efficiency and technical eontent, so as to optimize quality and enhance the overall strength of hospital. RSR method and comprehensive index method, considering the importance of medical evaluation index, can scientifically and objectively reflect the hospital medical quality, increase the efficiency of the analysis and make the evaluation more scientific and reasonable.