基于TOPSIS法对某公立医院分级诊疗运行情况的分析

Analysis of operation of hierarchical diagnosis and treatment in a public hospital based on TOPSIS method

目的以某公立医院为研究对象,对2015-2017年该医院实施分级诊疗制度前后的运行情况进行效果分析,并提出相应的建议。方法选取所研究医院的5个方面(医院人力资源发展、物力资源发展、整体服务效率发展、服务能力发展、财政发展)共14项指标,应用TOPSIS综合评价方法对分级诊疗运行情况进行分析。结果2015-2017年,目标医院的分级诊疗运行体系综合评价得分C_i逐年升高:2017年的综合得分最高,C_i值为0.956,2015年的综合得分最低,C_i值为0.258。2015-2017年,该医院总收入呈减少的趋势,国家财政补助逐年增加,药品收入占比逐年升高。结论实施分级诊疗制度后,该医院分级诊疗服务体系的建设情况改善明显,在三级医院首诊和转诊以及药品减费降费方面还有较大的进步空间。

Objective Taking a public hospital as the research object,to analyze the operation situation of the hospital before and after the implementation of hierarchical diagnosis and treatment system from 2015 to 2017,and to put forward corresponding suggestions.Methods A total of 14 indicators from 5 aspects(hospital human resources development,material resources development,overall service efficiency development,service capacity development,and financial development)of the studied hospital were selected,and TOPSIS comprehensive evaluation method was applied to analyze the hierarchical diagnosis and treatment operation.Results From 2015 to 2017,the comprehensive evaluation score C_i of the target hospital’s graded diagnosis and treatment operation system was increased annually:the highest comprehensive score in 2017,with a C_i value of 0.956,and the lowest overall score in 2015,with a C_i value of 0.258.From 2015 to 2017,the total income of the hospital showed a decreasing trend,the national financial subsidies increased annually,and the proportion of drug income increased annually.Conclusion After the implementation of the graded diagnosis and treatment system,the construction of the hospital’s graded diagnosis and treatment service system in the hospital has improved obviously.There is still much room for improvement in the first diagnosis and referral of third-level hospitals and the reduction of drug fees and charges.