我国三级公立医院新技术准入决策需求分析

Analysis on the decision-making need of new technology access of tertiary public hospitals in China

目的分析三级公立医院中医生、中层管理者、院级领导在新技术准入过程中关注的信息需求差异。方法于2018年1—10月在全国范围选取8个省份30家三级公立医院的医生和医院管理者共1200名,通过问卷调查收集不同岗位对医院新技术引入决策信息需求的重要性评分数据,利用SPSS 25.0软件对评分进行描述性统计分析。结果共获得有效问卷1032份。院级领导、中层管理者和医生对技术在国内外临床应用情况、安全性的信息需求评分均较高(4分以上,最高5分);院级领导、中层管理者对有效性、证据质量、被医疗保险覆盖的可能性、伦理性以及战略层面的相关指标评分较高,而医生对卫生经济学和组织层面的相关指标评分较高。结论三级公立医院不同岗位对于新技术准入的信息需求存在一定差异。对不同岗位决策需求偏重的了解有利于促进未来医院卫生技术评估标准在我国公立医院的实际落地。

Objective To analyze the differences in information needs of doctors,middle managers,and hospital leaders in tertiary public hospitals in the process of new technology access.Methods From January to October 2018,1200 doctors and hospital administrators from 30 tertiary public hospitals in 8 provinces were selected.The importance scores of different positions for decision-making information demand of new technology introduction were collected through questionnaire survey,and the scores were analyzed by SPSS 25.0 software.Descriptive statistical analysis was performed.Results 1032 valid questionnaires were obtained.Hospital-level leaders,middle-level managers,and doctors scored higher on the clinical application,safety,and effectiveness of technology at home and abroad(more than 4 points,maximum 5 points).Hospital-level leaders and middle-level managers had higher scores on effectiveness,evidence quality,possibility of being covered by medical insurance,ethics and relevant indicators of strategic level,while doctors had higher scores on health economics and organizational indicators.Conclusions There are some differences in the information demand for new technology access among different positions in tertiary public hospitals.Understanding the decision-making needs of different positions is conducive to promoting the actual implementation of hospital-based health technology assessment standards in China′s public hospitals.