床位分类管理供给侧利益相关者分析:以上海市某医疗集团骨科为例

Stakeholders analysis of bed classification management supply side-A case study of orthopedics in a medical group in Shanghai

目的:分析上海市某医疗集团下1所三级医院和1所二级医院骨科床位分类管理的合作意愿。方法:利用BDM模型分析2所医院骨科合作意愿。结果:双方合作意愿强烈,三级医院骨科并不依赖与该二级医院骨科的合作,而二级医院骨科非常依赖与该三级医院骨科的合作。结论:三级医院骨科具有就诊患者人数饱和的特点,二级医院骨科有接收三级医院骨科大部分转诊患者的能力。合作过程中存在三级医院骨科住院日可能被不合理压缩、转诊制度不完善、无风险管理和监管平台等问题。相关问题可通过制定患者治疗全程临床路径、规范患者转诊流程、建立转诊患者信息共享及监管平台等手段来解决。

Objective： To analyze the willingness to bed classification management cooperate of a tertiary level hospital and a secondary level hospital in a medical group in Shanghai. Methods： BDM model was used to analyze the willingness to cooperate of the two hospitals. Results： The willingness to cooperate of the two hospitals orthopedics is strong. The tertiary level hospital does not depend on cooperation with the secondary level hospital while the secondary level hospital heavily relies on cooperation with the tertiary level hospital. Conclusions： Patients of the tertiary level hospital orthopedics are saturated. The medical capacities of the secondary level hospital must pass assessment of the tertiary level hospital, and the secondary level hospital has the ability to receive the majority of referred patients. During the cooperation, the length of stay in the tertiary level hospital may be unreasonably compressed. The referral system is not completed and there is still no risk management or regulatory platform. These issues can be solved by developing clinical pathway throughout patients＇ treatment, standardizing referral process and establishing a referral information sharing and regulatory platform.