基于问卷和实地调研的我国医院评审工作评估

Evaluation of Hospital Accreditation in China Based on Questionnaires and Field Research

目的对我国医院评审工作进行评估。方法对全国29个省份的医务人员进行问卷调查,对上海市、江苏省、广东省、青海省、吉林省、北京市6省(市)进行实地调研,结合文献研究,理清我国医院评审的概况、获得的经验和遇到的问题以及相关的意见和建议。结果卫生健康行政部门主导医院评审工作获得广泛认同;医院评审是保证医疗质量、促进医院管理水平提升行之有效的方法;与第一周期医院评审工作相比,第二轮医院评审在促进分级诊疗、标准化管理等方面都有显著提高,在形式主义、劳民伤财和盲目购买设备等方面显著下降;部分医院长期处于“未评级”状态,社会办医的评审参与度不高;评审标准需要及时修订。结论(1)坚持政府主导的医院评审制度;(2)加强对评审工作的监督管理,做到“应评尽评”;(3)明确评审标准的更新周期;(4)稳步推进医疗信息统计评价,提高评审工作效率和结果的客观公平性;(5)增加医疗技术标准要求,简化管理标准;(6)探索评审员职业化、专业化工作,完善评审员制度。

Objective To evaluate the hospital accreditation in China.Methods Carrying out the questionnaire survey to medical staff in 29 provinces,municipalities and autonomous regions in China,carrying out the field research in 6 provinces and municipalities including Shanghai City,Jiangsu Province,Guangdong Province,Qinghai Province,Jilin Province and Beijing City,and combining with the literature research to make clear the general situation of hospital accreditation in China,the gained experience and the problems,and to propose relevant opinions and suggestions.Results The hospital accreditation work led by health administrative department has won wide recognition;the hospital accreditation is an effective method to ensure the medical treatment quality and facilitate the improvement of hospital management;compared with the first period of hospital accreditation,the second round of hospital accreditation has been significantly improved in promoting the hierarchical diagnosis and treatment and enhancing the standardized management,etc.,as well as has been significantly reduced in harassing the people and wasting money by formalism and purchasing the equipment blindly;some hospitals have been in the“unrated”state for a long term,and degree of participation of nongovernmental hospitals in the accreditation is not high;the accreditation standards need to be revised in time.Conclusion The suggestions are proposed,including(1)adhering to the government-led hospital accreditation system;(2)strengthening the supervision and management of accreditation work,so as to achieve“Accredit all those that shall be accredited”(3)specifying the time to update the hospital accreditation standards;(4)steadily promoting the statistical evaluation of medical information and improving the efficiency of accreditation and the objective fairness of results;(5)increasing the medical technical standards and simplify the management standards;(6)exploring the professionalization and specialization of accreditation personnel and improving the accreditation personnel system.