基于熵权TOPSIS-RSR法的江苏省公立三级甲等中医院医疗服务评价研究

Evaluation of medical services in tertiary public traditional Chinese medicine hospitals in Jiangsu Province based on entropy TOPSIS–RSR methodology

目的评价江苏省公立三级甲等中医院医疗服务情况,为“十四五”公立中医院医疗服务提质增效提供参考。方法基于熵权TOPSIS结合秩和比法对2018年—2020年江苏省15家公立三级甲等中医院进行评价。结果2020年开展手术例数的熵权最大,为0.193;2019年和2018年中医医疗服务项目收入的熵权最大,分别为0.353和0.273。按相对接近度C_(i)和概率单位Probit将江苏省15家公立三级甲等中医院医疗服务情况划分为好(Probit≥6.4)、中(4.8≤Probit<6.4)、差(Probit<4.8)3类,2018年、2019年、2020年各类中医院的数量依次为:1、8、6家,1、8、6家,1、7、7家。Kruskal-Wallis检验结果表明,2018年—2020年各类医院间的差异均具有统计学意义。结论各项评价指标中开展手术例数和中医医疗服务项目收入差异最大,江苏省公立三级甲等中医院医疗服务存在区域差异,同时苏南地区中医院医疗服务的吸引力形成扩大效应,建议优化完善政策保障机制,健全完善医疗服务体系,丰富创新医疗服务模式,以不断提升江苏省公立三级甲等中医院医疗服务能力和水平。

Objective To evaluate the medical services of public tertiary traditional Chinese medicine(TCM)hospitals in Jiangsu Province to provide evidence for improving the quality and efficiency of medical services in these hospitals in the“14 th Five-Year Plan”period.Methods Medical services in 15 public tertiary TCM hospitals in Jiangsu Province during the period from 2018 to 2014 were evaluated based on the entropy TOPSIS methodology.Results The entropy weight of the number of surgical cases in 2020(0.193)was the largest;the entropy weights of the revenue of TCM medical service items in 2019(0.353)and 2018(0.273)were the largest.By relative closeness(C_(i))and probability unit(Probit),the medical services in 15 public tertiary TCM hospitals in Jiangsu Province were divided into three categories:good(Probit≥6.4),medium(4.8≤Probit<6.4),and poor(Probit<4.8),with the number of TCM hospitals of various categories being 1/8/6,1/8/6,and 1/7/7 in 2018,2019,and 2020.Kruskal-Wallis test showed that the differences among all hospital categories were statistically significant in 2018-2020.Conclusions The differences in the number of surgical cases and the revenue from TCM services were the largest among the evaluation items,and there were regional differences in the medical services offered by these public tertiary TCM hospitals.Meanwhile,the attractiveness of the medical services of TCM hospitals in southern Jiangsu Province was rising.Efforts should be made to optimize regulations and policies,improve the medical service systems,and innovate the medical service modes,thus continuously enhancing capacity building of the medical services of public tertiary TCM hospitals in Jiangsu Province.