我国公立医院临床科室卫生服务经营管理现状及措施研究

Study on the current situation and service management reform in public hospitals in China

目的以北京积水潭医院呼吸与危重症医学科为例,分析我国公立医院临床科室卫生服务经营管理现状,并探讨干预措施。方法研究资料来源于2016年1月～2017年12月北京积水潭医院呼吸与危重症医学科医疗统计年报表,同时以管理干预为时间点于干预前后各随机选取500例患者,统计分析呼吸与危重症医学科工作人员现状,管理前后工作效率、医患关系、患者满意度。结果呼吸与危重症医学科现有工作人员69人,年龄分布呈纺锤形,硕士及以上15人,占21.74%,临床专业技术人员职称构成以初中级为主,占84.06%。管理干预后临床专业技术人员综合素质评分高于管理干预前,差异有高度统计学意义(P<0.01)。管理干预后,病床使用率、普通病床周转次数、监护病床周转次数以及病床效率指数均显著高于管理干预前(P<0.05)。管理干预后,医患关系优良率高于管理干预前、医疗纠纷发生率低于管理干预前,差异有高度统计学意义(P<0.01)。管理干预后患者满意度高于管理干预前,差异有高度统计学意义(P<0.01)。结论加强医院呼吸与危重症医学科卫生服务经营管理有助于提高人员综合素质及工作效率、降低医疗纠纷进而提高患者满意度,值得推广。

Objective To analyze the current situation in public hospitals in China and explore the intervention measures by taking Department of Respiratory and Critical Medical, Beijing Jishuitan Hospital as an example. Methods Study data were collected from the medical statistical annual report of the Department of Respiratory and Critical Care Medicine of Beijing Jishuitan Hospital from January 2016 to December 2017, and 500 patients were randomly selected with management intervention as the time point respectively. The present situation of the staff, work efficiency, doctorpatient relationship and patient satisfaction were statistically analyzed. Results There were 69 staff in the Department of Respiratory and Critical Care Medicine, with spindle-shape age distribution, 15 with a master degree or above, accounting for 21.74%. The professional title composition of clinical professional and technical personnel was mainly in the primary and middle level, accounting for 84.06%. After management intervention, the comprehensive quality score of clinical professional and technical personnel was statistically higher than that before management intervention, the difference was highly significant(P < 0.01). After management intervention, the sickbed utilization rate, the turnover number of common beds, the turnover number of monitoring beds and the efficiency index of beds were significantly higher than those before management intervention(P < 0.05). After management intervention, The excellent and good rate of doctor-patient relationship was higher than that before management intervention and the incidence of medical disputes was lower than that before management intervention, the difference was highly significant(P < 0.01). After management intervention, patient satisfaction was higher than that before management intervention, and the difference was highly statistically significant(P < 0.01). Conclusion Strengthening the operation and management of hospital respiratory and critical care medical services is helpful to improve the comprehensive quality and work efficiency of personnel, to reduce medical disputes and improve the satisfaction of patients, which is worth of promotion.