三级妇幼保健院主要结果质量指标现状分析

Analysis of main result quality indicators of tertiary maternal and child health hospitals

目的了解三级妇幼保健院主要的结果质量指标情况,为决策提供依据。方法利用全国妇幼保健机构资源及运营情况调查直报系统,收集分析2017年我国三级妇幼保健院管理运行、住院死亡、重返情况、医院感染、手术并发症及患者安全情况。采用平均值、率和构成比对资料进行统计描述。结果2017年,全国三级妇幼保健院共有卫生技术人员139292人,占职工总数的83.66%;平均住院日5.96天,床位使用率90.01%。新生儿复苏成功率较高;未参与评审的机构,其住院孕产妇危重症死亡率、新生儿患者总住院死亡率、手术患者并发症发生率、新生儿产伤发生率和阴道分娩产妇产伤发生率较高。结论我国三级妇幼保健院管理运行情况良好,相关政策和项目成效显著。与综合医院相比,医院感染和重返类指标情况较好。未参与过评审的三级妇幼保健院质量安全状况相对较差,建议加强监管,提升质量安全。

Objective To acquire the main result quality indicators status of tertiary maternal and child health(MCH)hospitals in China,supporting the decision making.Methods The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the management operation,inpatient death,re-return,hospital-acquired infection,surgical complications and patient safety of these hospitals in China in 2017.Statistical descriptions were made using average,rate and composition comparison data.Results The proportion of health technicians of tertiary MCH hospitals in China was 83.66%,the average hospitalization days were 5.96 days,with bed occupancy rate of 90.01%.The success rate of neonatal resuscitation was high.Meanwhile,the mortality rate of hospitalized maternal critical illness,the total hospitalization mortality rate of neonatal patients,the incidence of complications in surgical patients,the incidence of neonatal injury and the incidence of birth injury in vaginal delivery were higher in the institutions that had not participated in the MCH hospital accreditation.Conclusions The management of tertiary MCH hospitals in China was in good condition,and the relevant policies and projects have achieved remarkable results.Compared with general hospitals,hospital infection and re-return indicators were good.The quality and safety of tertiary MCH hospitals which have not participated in the MCH hospital assessment were poor.It is recommended to carry out MCH hospital accreditation to improve quality and safety.