病人安全文化与医疗服务结局的关联性分析

Association of Patient Safety Culture and Medical Service Outcomes

目的探讨病人安全文化与医疗服务结局的关联性。方法采用自行设计的病案评阅表对我国东、中、西3省市18所公立医院的社区获得性肺炎、急性心肌梗死、急性左心功能衰竭、计划性剖宫产和胆囊结石合并急性胆囊炎5个病种进行调查;通过机构问卷调查,收集医院层面的医疗服务状况数据;采用中国版医疗机构病人安全文化调查量表进行病人安全文化调查。结果在医院层面上,未发现病人安全文化与医疗服务状况各指标的关联性;在病种层面上,多因素分析也未显示病人安全文化与治愈好转状况、住院天数和住院总费用的关联性。结论病人安全文化对医疗服务结局的影响不显著,可能是通过间接途径作用于医疗服务结局。

Objective To examine the association of patient safety culture（PSC） and medical service outcomes. Methods Medical records of community- acquired pneumonia, acute myocardial infarction, acute left ventricular failure,planned cesarean section and gallstones associated with acute cholecystitis in 18 public hospitals of 3 provinces（or municipality） from eastern,central,western regions in China were reviewed. Data related to hospital medical services was collected by hospital survey. PSC was measured through using the Chinese version of PSCHO. Results No significant associations are found between patient outcomes and PSC both at hospital level and at patient level. Multi-factors analysis shows no signs of the correlation of patient safety culture and cure situation,hospitalization days and hospitalization cost. Conclusion The impact of PSC on patient outcomes is not significant and may be indirectly correlated with medical service outcomes.